CN115698719A - Methods and compositions for cancer immunotherapy - Google Patents

Methods and compositions for cancer immunotherapy Download PDF

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CN115698719A
CN115698719A CN202180041949.4A CN202180041949A CN115698719A CN 115698719 A CN115698719 A CN 115698719A CN 202180041949 A CN202180041949 A CN 202180041949A CN 115698719 A CN115698719 A CN 115698719A
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sequence
individual
hvr
antagonist antibody
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S·穆勒
B·Y·纳贝特
N·S·帕蒂尔
R·F·班奇罗
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Genentech Inc
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    • C12Q1/00Measuring or testing processes involving enzymes, nucleic acids or microorganisms; Compositions therefor; Processes of preparing such compositions
    • C12Q1/68Measuring or testing processes involving enzymes, nucleic acids or microorganisms; Compositions therefor; Processes of preparing such compositions involving nucleic acids
    • C12Q1/6876Nucleic acid products used in the analysis of nucleic acids, e.g. primers or probes
    • C12Q1/6883Nucleic acid products used in the analysis of nucleic acids, e.g. primers or probes for diseases caused by alterations of genetic material
    • C12Q1/6886Nucleic acid products used in the analysis of nucleic acids, e.g. primers or probes for diseases caused by alterations of genetic material for cancer
    • GPHYSICS
    • G01MEASURING; TESTING
    • G01NINVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N33/00Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
    • G01N33/48Biological material, e.g. blood, urine; Haemocytometers
    • G01N33/50Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
    • G01N33/53Immunoassay; Biospecific binding assay; Materials therefor
    • G01N33/574Immunoassay; Biospecific binding assay; Materials therefor for cancer
    • G01N33/57407Specifically defined cancers
    • G01N33/57423Specifically defined cancers of lung
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00Antineoplastic agents
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07KPEPTIDES
    • C07K16/00Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
    • C07K16/18Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans
    • C07K16/28Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants
    • C07K16/2803Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants against the immunoglobulin superfamily
    • C07K16/2827Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans against receptors, cell surface antigens or cell surface determinants against the immunoglobulin superfamily against B7 molecules, e.g. CD80, CD86
    • GPHYSICS
    • G01MEASURING; TESTING
    • G01NINVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N33/00Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
    • G01N33/48Biological material, e.g. blood, urine; Haemocytometers
    • G01N33/50Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
    • G01N33/53Immunoassay; Biospecific binding assay; Materials therefor
    • G01N33/569Immunoassay; Biospecific binding assay; Materials therefor for microorganisms, e.g. protozoa, bacteria, viruses
    • G01N33/56966Animal cells
    • G01N33/56972White blood cells
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    • C12Q2600/00Oligonucleotides characterized by their use
    • C12Q2600/106Pharmacogenomics, i.e. genetic variability in individual responses to drugs and drug metabolism
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    • C12BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
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    • C12Q2600/00Oligonucleotides characterized by their use
    • C12Q2600/158Expression markers
    • GPHYSICS
    • G01MEASURING; TESTING
    • G01NINVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N2800/00Detection or diagnosis of diseases
    • G01N2800/52Predicting or monitoring the response to treatment, e.g. for selection of therapy based on assay results in personalised medicine; Prognosis

Abstract

The present invention provides diagnostic methods, therapeutic methods and compositions for treating cancer. The compositions and methods described herein can be used, for example, to identify patients with cancer who may benefit from treatment with a PD-L1 axis binding antagonist and to treat such patients accordingly. Using the compositions and methods of the present disclosure, a patient, such as a human cancer patient, may be determined to be likely to benefit from treatment with a PD-L1 axis binding antagonist if the patient exhibits the presence or elevated expression levels of any of the biomarkers disclosed herein. Exemplary PD-L1 axis binding antagonists that can be used in conjunction with the compositions and methods of the present disclosure are PD-L1 binding antagonists, such as anti-PD-L1 antibodies and antigen-binding fragments thereof, including attentizumab; and PD-1 binding antagonists, such as anti-PD-1 antibodies and antigen-binding fragments thereof.

Description

Methods and compositions for cancer immunotherapy
Sequence listing
This application contains a sequence listing that has been submitted electronically in ASCII format and is incorporated by reference herein in its entirety. The ASCII copy was created at 11.6.2021, named 50474-209WO2_sequence_listing_6.11.21_ST25, and was 398,463 bytes in size.
Cross reference to related patent applications
This application claims priority to U.S. provisional patent application No. 63/038,559, filed on 12/6/2020, the contents of which are incorporated herein by reference in their entirety.
Technical Field
The present invention relates to diagnostic and therapeutic methods for treating cancer using PD-L1 axis binding antagonists. Related kits and compositions are also provided.
Background
Cancer remains one of the most fatal threats to human health. In the united states, cancer affects nearly 130 million new patients each year, second only to heart disease, the second leading cause of death, accounting for approximately one-fourth of all deaths. In addition, it is predicted that cancer may be the first leading cause of death beyond cardiovascular disease within 5 years. Solid tumors are the leading cause of these deaths.
Human studies with immune checkpoint inhibitors have demonstrated the promise of using the immune system to control and eradicate tumor growth. The programmed death 1 (PD-1) receptor and its ligand programmed death ligand 1 (PD-L1) are immune checkpoint proteins associated with suppression of immune system responses during chronic infections, pregnancy, allografts, autoimmune diseases, and cancer. PD-L1 modulates immune responses by binding to the inhibitory receptor PD-1, which is expressed on the surface of T cells, B cells and monocytes. PD-L1 also exerts negative regulation of T cell function by interacting with another receptor, B7-1. The formation of the PD-L1/PD-1 and PD-L1/B7-1 complex down-regulates T cell receptor signaling, leading to down-regulation of T cell activation and inhibition of anti-tumor immune activity.
Despite major advances in the medical treatment of certain cancers, the 5-year overall survival rate of all cancers has only increased by about 10% over the past 20 years. In particular, malignant solid tumors metastasize and grow in an uncontrolled manner, which makes timely discovery and treatment extremely difficult.
Despite the great advances in cancer therapy, improved diagnostic and therapeutic methods and cancer therapies are sought.
Disclosure of Invention
The present disclosure provides therapeutic and diagnostic methods and compositions for treating an individual having cancer, e.g., lung cancer (e.g., non-small cell lung cancer (NSCLC)), endometrial cancer, colon adenocarcinoma, renal cell carcinoma, bladder cancer (e.g., urothelial Cancer (UC)), renal cancer (e.g., renal Cell Carcinoma (RCC)), and breast cancer (e.g., triple Negative Breast Cancer (TNBC)).
In one aspect, the invention features a method of identifying an individual having cancer who is likely to benefit from treatment with a PD-L1 axis binding antagonist, the method comprising determining the expression levels of two or more of the genes CD79A, CD19, BANK1, jchanin, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual, wherein the individual is identified as an individual who is likely to benefit from treatment with a PD-L1 axis binding antagonist if the immune score expression levels of the two or more genes are greater than reference immune score expression levels of the two or more genes.
In another aspect, the invention features a method of selecting a therapy for an individual having cancer, the method comprising determining the expression levels of two or more of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual, wherein the individual is identified as an individual likely to benefit from treatment comprising a PD-L1 axis binding antagonist if the immune score expression level of the two or more genes is greater than a reference immune score expression level of the two or more genes.
In some aspects, the immune score expression level of the two or more genes in the sample is higher than the reference immune score expression level, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another aspect, the invention features a method of treating a subject having cancer, the method including: (a) Determining the expression level of two or more of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual, wherein the determination of the immune score expression level of the two or more genes in the sample is higher than a reference immune score expression level of the two or more genes; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another aspect, the invention features a method of treating cancer in an individual, wherein the individual has been determined to have in a sample from the individual an immune score expression level of two or more of the genes CD79A, CD19, BANK1, jchan, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 that is greater than a reference immune score expression level for the two or more genes, the method comprising administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another aspect, the invention features a PD-L1 axis binding antagonist for use in a method of treating an individual having cancer, the method comprising: (a) Determining the expression level of two or more of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual, wherein the determination of the immune score expression level of the two or more genes in the sample is higher than a reference immune score expression level of the two or more genes; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another aspect, the invention features a PD-L1 axis binding antagonist for use in treating cancer in an individual, wherein the individual has been determined to have in a sample from the individual an immune score expression level of two or more of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 that is higher than a reference immune score expression level of the two or more genes.
In some aspects, the immune score reference expression level is an immune score expression level of two or more genes in a reference population.
In some aspects, the reference population is a population of individuals with cancer.
In some aspects, the population of individuals includes a first subset of individuals who have received treatment with a PD-L1 axis binding antagonist and a second subset of individuals who have received treatment with a therapy that does not contain a PD-L1 axis binding antagonist.
In some aspects, the reference immune score expression level visibly differentiates each of the first subset of individuals from the second subset of individuals based on a significant difference between the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist and the responsiveness of the individual to treatment with the therapy without the PD-L1 axis binding antagonist above the reference immune score expression level, wherein the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist is significantly improved relative to the responsiveness of the individual to treatment with the therapy without the PD-L1 axis binding antagonist.
In some aspects, the therapy without a PD-L1 axis binding antagonist comprises an anti-neoplastic agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, or a combination thereof.
In some aspects, the therapy without the PD-L1 axis binding antagonist comprises a chemotherapeutic agent.
In some aspects, the chemotherapeutic agent is docetaxel.
In some aspects, responsiveness to treatment comprises prolongation of OS, prolongation of Progression Free Survival (PFS), or an increase in the determined optimal overall response (BCOR).
In some aspects, responsiveness to treatment is an extension of Overall Survival (OS).
In some aspects, the reference immune score expression level is the median of the expression levels of each of the two or more genes in the reference population.
In some aspects, the genes include three or more of CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB 1.
In some aspects, the genes include four or more of CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB 1.
In some aspects, the genes include five or more of CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB 1.
In some aspects, the genes include six or more of CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB 1.
In some aspects, the genes include seven or more of CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB 1.
In some aspects, the genes include CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1.
In another aspect, the invention features a method of identifying an individual having cancer who is likely to benefit from treatment with a PD-L1 axis binding antagonist, the method comprising determining the expression level of one or more of the genes CD79A, CD19, BANK1, jcha in, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual, wherein the individual is identified as an individual who is likely to benefit from treatment with the PD-L1 axis binding antagonist if the immune score expression level of the one or more genes is greater than a reference immune score expression level for the one or more genes, wherein the benefit comprises an increase in Overall Survival (OS) of the individual as compared to treatment without the PD-L1 axis binding antagonist.
In another aspect, the invention features a method of selecting a therapy for an individual having cancer, the method comprising determining the expression level of one or more of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual, wherein the individual is identified as an individual likely to benefit from treatment with a PD-L1 axis binding antagonist in the event that the immune score expression level of the one or more genes is greater than a reference immune score expression level for the one or more genes, wherein the benefit comprises a prolongation of OS in the individual as compared to treatment without the PD-L1 axis binding antagonist.
In some aspects, the immune score expression level of one or more genes in the sample is greater than the reference immune score expression level, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another aspect, the invention features a method of treating a subject having cancer, the method including: (a) Determining the expression level of one or more of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual, wherein determining the immune score expression level of the one or more genes in the sample is greater than a reference immune score expression level for the one or more genes identifies the individual as a likely to benefit from treatment comprising a PD-L1 axis binding antagonist, wherein the benefit comprises an increase in OS in the individual as compared to treatment without the PD-L1 axis binding antagonist; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another aspect, the invention features a method of treating cancer in an individual, wherein the individual has been determined to have an immune score expression level of one or more of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual that is greater than a reference immune score expression level for the one or more genes, the method comprising administering to the individual an effective amount of a PD-L1 axis binding antagonist, wherein in the event the immune score expression level of the one or more genes is greater than the reference immune score expression level for the one or more genes, identifying the individual as likely to benefit from treatment with a PD-L1 axis binding antagonist, wherein the benefit comprises a prolonged OS in the individual as compared to treatment without the PD-L1 axis binding antagonist.
In another aspect, the invention features a PD-L1 axis binding antagonist for use in a method of treating an individual having cancer, the method comprising: (a) Determining the expression level of one or more of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual, wherein determining the immune score expression level of the one or more genes in the sample is greater than a reference immune score expression level for the one or more genes identifies the individual as a likely to benefit from treatment comprising a PD-L1 axis binding antagonist, wherein the benefit comprises an increase in OS in the individual as compared to treatment without the PD-L1 axis binding antagonist; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another aspect, the invention features a PD-L1 axis binding antagonist for use in treating cancer in an individual, wherein the individual has been determined to have an immune score expression level of one or more of genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual that is higher than a reference immune score expression level of the one or more genes, wherein in the event that the immune score expression level of the one or more genes is higher than the reference immune score expression level of the one or more genes, the individual is identified as an individual who is likely to benefit from treatment with the PD-L1 axis binding antagonist, wherein the benefit comprises an extended OS in the individual as compared to treatment without the PD-L1 axis binding antagonist.
In some aspects, the level of immune score expression of one of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 is determined.
In some aspects, the level of immune score expression of CD79A is determined.
In some aspects, the immune score reference expression level is an immune score expression level of one or more genes in a reference population.
In some aspects, the reference population is a population of individuals with cancer.
In some aspects, the population of individuals includes a first subset of individuals who have received treatment with a PD-L1 axis binding antagonist and a second subset of individuals who have received treatment with a therapy that does not contain a PD-L1 axis binding antagonist.
In some aspects, the reference expression level of the immune score is based on a significant difference between the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist and the responsiveness of the individual to treatment with therapy that does not contain the PD-L1 axis binding antagonist above the reference expression level, distinctly distinguishing each of the first subset of individuals from the second subset of individuals, wherein the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist is significantly improved relative to the responsiveness of the individual to treatment with therapy that does not contain the PD-L1 axis binding antagonist.
In some aspects, the therapy without a PD-L1 axis binding antagonist comprises an anti-tumor agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, or a combination thereof.
In some aspects, the therapy without the PD-L1 axis binding antagonist comprises a chemotherapeutic agent.
In some aspects, the chemotherapeutic agent is docetaxel.
In some aspects, responsiveness to treatment comprises a prolongation of OS, a prolongation of PFS, or an increase in BCOR.
In some aspects, responsiveness to treatment is an extension of Overall Survival (OS).
In some aspects, the immune score reference expression level is the median of the expression levels of each of the one or more genes in the reference population.
In some aspects, the median expression level is the median of the mean Z scores of the expression levels of each of the two or more genes in the reference population.
In some aspects, the genes include two or more of CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB 1.
In some aspects, the two or more genes include TNFRSF17 and IGJ.
In some aspects, the two genes consist of TNFRSF17 and IGJ.
In some aspects, the genes include three or more of CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB 1.
In some aspects, the genes include four or more of CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1.
In some aspects, the genes include five or more of CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1.
In some aspects, the genes include six or more of CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1.
In some aspects, the genes include seven or more of CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1.
In some aspects, the genes include CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1.
In another aspect, the invention features a method of identifying an individual having cancer who is likely to benefit from treatment with a PD-L1 axis binding antagonist, the method including determining the expression level of one or more of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 in a sample from the individual, wherein the individual is identified as an individual who is likely to benefit from treatment with a PD-L1 axis binding antagonist if the immune score expression level of the one or more genes is higher than the reference immune score expression level of the one or more genes.
In another aspect, the invention features a method of selecting a therapy for an individual having cancer, the method comprising determining the expression level of one or more of the genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 in a sample from the individual, wherein the individual is identified as an individual likely to benefit from treatment with a PD-L1 axis binding antagonist if the immune score expression level of the one or more genes is greater than a reference immune score expression level of the one or more genes.
In some embodiments of any of the foregoing two aspects, the immune score expression level of the one or more genes in the sample is greater than the reference immune score expression level, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In other aspects, the invention features a method of treating an individual having cancer, the method including:
(a) Determining in a sample from the individual the expression level of one or more of the genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5, wherein the immune score expression level of the one or more genes in the sample is determined to be higher than a reference immune score expression level of the one or more genes; and
(b) Administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another aspect, the invention features a method of treating cancer in an individual, wherein the individual has been determined to have an immune score expression level of one or more of the genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 in a sample from the individual that is higher than a reference immune score expression level for the one or more genes, comprising administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In some embodiments, the immune score reference expression level is an immune score expression level of one or more genes in a reference population.
In some embodiments, the reference population is a population of individuals having cancer.
In some embodiments, the population of individuals includes a first subset of individuals who have received treatment with a PD-L1 axis binding antagonist and a second subset of individuals who have received treatment with a therapy that does not contain a PD-L1 axis binding antagonist.
In some embodiments, the reference immune score expression level visibly differentiates each of the first subset of individuals from the second subset of individuals based on a significant difference between the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist and the responsiveness of the individual to treatment with the therapy without the PD-L1 axis binding antagonist above the reference immune score expression level, wherein the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist is significantly improved relative to the responsiveness of the individual to treatment with the therapy without the PD-L1 axis binding antagonist.
In some embodiments, the therapy without the PD-L1 axis binding antagonist comprises an anti-neoplastic agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, or a combination thereof.
In some embodiments, the therapy without the PD-L1 axis binding antagonist comprises a chemotherapeutic agent.
In some embodiments, the chemotherapeutic agent is docetaxel.
In some embodiments, responsiveness to treatment comprises prolongation of OS, prolongation of PFS, or an increase in BCOR.
In some embodiments, responsiveness to treatment includes an extension of Overall Survival (OS).
In some embodiments, the reference immune score expression level is the median of the expression levels of each of the one or more genes in the reference population.
In some embodiments, the genes include two or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
In some embodiments, the genes include three or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
In some embodiments, the genes include four or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
In some embodiments, the genes include five or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
In some embodiments, the genes include six or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
In some embodiments, the genes include seven or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
In some embodiments, the genes include eight or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
In some embodiments, the genes include nine or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
In some embodiments, the genes include ten or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
In some embodiments, the genes comprise eleven or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, or IGLL5.
In some embodiments, the genes include twelve or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, or IGLL5.
In some embodiments, the genes include thirteen or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, or IGLL5.
In some embodiments, the genes include MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5.
In another aspect, the invention features a method of identifying an individual having cancer who is likely to benefit from treatment with a PD-L1 axis binding antagonist, the method including determining the expression level of one or more of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 in a sample from the individual, wherein the benefit includes an increase in OS of the individual as compared to treatment without the PD-L1 axis binding antagonist, where the immune score expression level of the one or more genes is greater than a reference immune score expression level for the one or more genes.
In another aspect, the invention features a method of selecting a therapy for an individual having cancer, the method comprising determining the expression level of one or more of the genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 in a sample from the individual, wherein in the event the immune score expression level of the one or more genes is greater than a reference immune score expression level for the one or more genes, identifying the individual as an individual likely to benefit from treatment with a PD-L1 axis binding antagonist, wherein the benefit comprises an extended OS in the individual as compared to treatment without the PD-L1 axis binding antagonist.
In some embodiments of any of the foregoing two aspects, the immune score expression level of the one or more genes in the sample is greater than the reference immune score expression level, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another aspect, the invention features a method of treating a subject having cancer, the method including:
(a) Determining in a sample from the individual the expression level of one or more of the genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5, wherein determining the immune score expression level of the one or more genes in the sample is higher than a reference immune score expression level of the one or more genes, thereby identifying the individual as an individual who is likely to benefit from treatment comprising a PD-L1 axis binding antagonist, wherein the benefit comprises a prolongation of OS in the individual as compared to treatment without the PD-L1 axis binding antagonist; and
(b) Administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another aspect, the invention features a method of treating cancer in an individual, wherein the individual has been determined to have an immune score expression level of one or more of the genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7 and IGLL5 in a sample from the individual that is higher than a reference immune score expression level of the one or more genes, the method comprising administering to the individual an effective amount of a PD-L1 axis binding antagonist, wherein the benefit comprises identifying the individual as an individual likely to benefit from treatment with the PD-L1 axis binding antagonist, wherein the benefit comprises a prolonged OS in the individual compared to treatment without the PD-L1 axis binding antagonist.
In some embodiments, the immune score reference expression level is an immune score expression level of one or more genes in a reference population.
In some embodiments, the reference population is a population of individuals with cancer.
In some embodiments, the population of individuals includes a first subset of individuals who have received treatment with a PD-L1 axis binding antagonist and a second subset of individuals who have received treatment with a therapy that does not contain a PD-L1 axis binding antagonist.
In some embodiments, the reference expression level of the immune score is based on a significant difference between the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist and the responsiveness of the individual to treatment with therapy that does not contain the PD-L1 axis binding antagonist above the reference expression level, distinctly distinguishing each of the first subset of individuals from the second subset of individuals, wherein the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist is significantly improved relative to the responsiveness of the individual to treatment with therapy that does not contain the PD-L1 axis binding antagonist.
In some embodiments, the therapy without a PD-L1 axis binding antagonist comprises an anti-tumor agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, or a combination thereof.
In some embodiments, the therapy without the PD-L1 axis binding antagonist comprises a chemotherapeutic agent.
In some embodiments, the chemotherapeutic agent is docetaxel.
In some embodiments, responsiveness to treatment comprises prolongation of OS, prolongation of PFS, or an increase in BCOR.
In some embodiments, responsiveness to treatment includes an extension of Overall Survival (OS).
In some embodiments, the immune score reference expression level is the median of the expression levels of each of the one or more genes in the reference population.
In some embodiments, the median expression level is the median of the mean Z scores for the expression levels of each of the one or more genes in the reference population.
In some embodiments, the genes include two or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
In some embodiments, the genes include three or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
In some embodiments, the genes include four or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
In some embodiments, the genes include five or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
In some embodiments, the genes include six or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
In some embodiments, the genes include seven or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, or IGLL 5.
In some embodiments, the genes include eight or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
In some embodiments, the genes include nine or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
In some embodiments, the genes include ten or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
In some embodiments, the genes include eleven or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
In some embodiments, the genes include twelve or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5.
In some embodiments, the genes include thirteen or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5.
In some embodiments, the genes include MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5.
In another aspect, the invention features a method of identifying an individual having cancer who is likely to benefit from treatment with a composition comprising a PD-L1 axis binding antagonist, the method including determining the presence of a Tertiary Lymphoid Structure (TLS) in a tumor sample from the individual, wherein the presence of TLS in the tumor sample identifies the individual as an individual who is likely to benefit from treatment with a composition comprising a PD-L1 axis binding antagonist.
In another aspect, the invention features a method of selecting a therapy for an individual with cancer, the method comprising determining the presence of TLS in a tumor sample from the individual, wherein the presence of TLS in the tumor sample identifies the individual as an individual who is likely to benefit from treatment comprising a PD-L1 axis binding antagonist.
In some aspects, the presence of TLS is determined in a sample from the individual, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another aspect, the invention features a method of treating a subject having cancer, the method including: (a) Determining the presence of TLS in a tumor sample from the individual; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another aspect, the invention features a method of treating cancer in an individual, wherein the individual has been determined to have TLS present in a tumor sample from the individual, comprising administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another aspect, the invention features a PD-L1 axis binding antagonist for use in a method of treating an individual having cancer, the method comprising: (a) Determining the presence of TLS in a tumor sample from the individual; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another aspect, the invention features a PD-L1 axis binding antagonist for use in treating cancer in an individual, wherein the individual is determined to have TLS present in a tumor sample from the individual.
In some aspects, the presence of TLS is determined by histological staining, immunohistochemistry (IHC), immunofluorescence, or gene expression analysis.
In some aspects, the histological stain comprises a hematoxylin and eosin (H & E) stain.
In some aspects, IHC or immunofluorescence comprises detecting CD62L, L-selectin, CD40, or CD8.
In some aspects, the CD62L or L-selectin is detected using a MECA-79 antibody.
In some aspects, the gene expression analysis comprises determining the expression level of a TLS gene signature in the sample.
In some aspects, the TLS gene signature comprises one or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13.
In some aspects, the gene comprises two or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13.
In another aspect, the invention features a method of identifying an individual having cancer who may benefit from treatment comprising a PD-L1 axis binding antagonist, the method comprising determining expression levels of two or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from the individual, wherein the individual is identified as an individual who may benefit from treatment comprising a PD-L1 axis binding antagonist if the immune score expression levels of the two or more genes are greater than reference immune score expression levels of the two or more genes.
In another aspect, the invention features a method of selecting a therapy for an individual having cancer, the method comprising determining an expression level of two or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from the individual, wherein the individual is identified as an individual likely to benefit from treatment comprising a PD-L1 axis binding antagonist if the immune score expression level of the two or more genes is greater than a reference immune score expression level of the two or more genes.
In some aspects, the immune score expression level of two or more genes in the sample is greater than the reference immune score expression level, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another aspect, the invention features a method of treating a subject having cancer, the method including: (a) Determining an expression level of two or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from the individual, wherein determining an immune score expression level of the two or more genes in the sample is higher than a reference immune score expression level of the two or more genes; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another aspect, the invention features a method of treating cancer in an individual, wherein the individual has been determined to have an immune score expression level of two or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from the individual that is higher than a reference immune score expression level of the two or more genes, the method comprising administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another aspect, the invention features a PD-L1 axis binding antagonist for use in a method of treating an individual having cancer, the method comprising: (a) Determining an expression level of two or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from the individual, wherein determining an immune score expression level of the two or more genes in the sample is higher than a reference immune score expression level of the two or more genes; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another aspect, the invention features a PD-L1 axis binding antagonist for use in treating cancer in an individual, wherein the individual has been determined to have an immune score expression level of two or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from the individual that is higher than a reference immune score expression level of the two or more genes.
In some aspects, the reference immune score expression level is an immune score expression level of two or more genes in a reference population.
In some aspects, the reference population is a population of individuals with cancer.
In some aspects, the population of individuals includes a first subset of individuals who have received treatment with a PD-L1 axis binding antagonist and a second subset of individuals who have received treatment with a therapy that does not contain a PD-L1 axis binding antagonist.
In some aspects, the reference immune score expression level clearly distinguishes each of the first subset of individuals from the second subset of individuals based on a significant difference between the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist and the responsiveness of the individual to treatment with the therapy that does not contain the PD-L1 axis binding antagonist above the reference expression level, wherein the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist is significantly improved relative to the responsiveness of the individual to treatment with the therapy that does not contain the PD-L1 axis binding antagonist.
In some aspects, the therapy without a PD-L1 axis binding antagonist comprises an anti-neoplastic agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, or a combination thereof.
In some aspects, the therapy without the PD-L1 axis binding antagonist comprises a chemotherapeutic agent.
In some aspects, the chemotherapeutic agent is docetaxel.
In some aspects, responsiveness to treatment comprises a prolongation of OS, a prolongation of PFS, or an increase in BCOR.
In some aspects, responsiveness to treatment is an extension of Overall Survival (OS).
In some aspects, the reference immune score expression level is the median of the expression levels of each of the two or more genes in the reference population.
In some aspects, the median expression level is the median of the mean Z scores of the expression levels of each of the two or more genes in the reference population.
In some aspects, the gene comprises three or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13.
In some aspects, the gene comprises four or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13.
In some aspects, the gene comprises five or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13.
In some aspects, the gene comprises six or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13.
In some aspects, the gene comprises seven or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13.
In some aspects, the gene comprises eight or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13.
In some aspects, the genes include nine or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13.
In some aspects, the gene comprises ten or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13.
In some aspects, the gene comprises eleven or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13.
In some aspects, the gene comprises CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13.
In some aspects, the expression level is a nucleic acid expression level.
In some aspects, the nucleic acid expression level is an mRNA expression level.
In some aspects, mRNA expression levels are determined by RNA-seq, RT-qPCR, multiplex qPCR or RT-qPCR, microarray analysis, SAGE, massARRAY technology, FISH, or combinations thereof.
In some aspects, mRNA expression levels are detected using RNA-seq.
In some aspects, the expression level is a protein expression level.
In some aspects, the protein expression level is determined by IHC, immunofluorescence, mass spectrometry, flow cytometry, and western blot, or a combination thereof.
In some aspects, the expression level is detected in tumor cells, tumor infiltrating immune cells, stromal cells, paracancerous normal tissue (NAT) cells, or a combination thereof.
In another aspect, the invention features a method of identifying an individual having cancer who is likely to benefit from treatment with a PD-L1 axis binding antagonist, the method including determining the number of B cells in a tumor sample from the individual, wherein the individual is identified as an individual who is likely to benefit from treatment with a PD-L1 axis binding antagonist if the number of B cells in the tumor sample is greater than a reference number of B cells.
In another aspect, the invention features a method of selecting a therapy for an individual having cancer, the method including determining a number of B cells in a tumor sample from the individual, wherein the individual is identified as an individual likely to benefit from treatment with a PD-L1 axis binding antagonist if the number of B cells in the tumor sample is greater than a reference number of B cells.
In some aspects, the number of B cells in the sample is greater than the reference number, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another aspect, the invention features a method of treating a subject having cancer, the method including: (a) Determining the number of B cells in a tumor sample from the individual; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another aspect, the invention features a method of treating cancer in an individual, wherein the individual has been determined to have a number of B cells in a tumor sample from the individual that is greater than a reference number of B cells, the method comprising administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another aspect, the invention features a PD-L1 axis binding antagonist for use in a method of treating an individual having cancer, the method comprising: (a) Determining the number of B cells in a tumor sample from the individual; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another aspect, the invention features a PD-L1 axis binding antagonist for use in treating cancer in an individual, wherein the individual has been determined to have a number of B cells in a tumor sample from the individual that is higher than a reference number of B cells.
In some aspects, B cells include CD79+ B cells, igG + B cells, and/or plasma cells.
In another aspect, the invention features a method of identifying an individual having cancer who is likely to benefit from treatment with a compound comprising a PD-L1 axis binding antagonist, the method including determining whether the individual has clonally expanded B cells in a tumor sample from the individual, wherein the clonally expanded B cells in the sample identify the individual as an individual who is likely to benefit from treatment with a compound comprising a PD-L1 axis binding antagonist.
In another aspect, the invention features a method of selecting a therapy for an individual with cancer, the method including determining whether the individual has clonally expanded B cells in a tumor sample from the individual, wherein the clonally expanded B cells in the sample identify the individual as an individual likely to benefit from treatment comprising a PD-L1 axis binding antagonist.
In some aspects, the tumor sample comprises clonally expanded B cells, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another aspect, the invention features a method of treating a subject having cancer, the method including: (a) Determining that the individual has clonally expanded B cells in a tumor sample from the individual; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another aspect, the invention features a method of treating cancer in an individual, wherein the individual has been determined to have clonally expanded B cells in a tumor sample from the individual, the method comprising administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another aspect, the invention features a PD-L1 axis binding antagonist for use in a method of treating an individual having cancer, the method comprising: (a) Determining that the individual has clonally expanded B cells in a tumor sample from the individual; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another aspect, the invention features a PD-L1 axis binding antagonist for use in treating cancer in an individual, wherein the individual has been determined to have clonally expanded B cells in a tumor sample from the individual.
In some aspects, the clonally expanded B cells are clonally expanded plasma cells.
In some aspects, clonally expanded B cells are detected by measuring the diversity of B Cell Receptor (BCR) gene lineages in a tumor sample.
In some aspects, where a Shannon Diversity Index (SDI) of a BCR gene lineage in a tumor sample from an individual is lower than a reference SDI, the individual is identified as an individual who is likely to benefit from treatment comprising a PD-L1 axis binding antagonist.
In some aspects, the sample is a tissue sample, a cell sample, a whole blood sample, a plasma sample, a serum sample, or a combination thereof.
In some aspects, the tissue sample is a tumor tissue sample.
In some aspects, the tumor sample is a tumor tissue sample.
In some aspects, the tumor tissue sample comprises tumor cells, tumor infiltrating immune cells, stromal cells, NAT cells, or combinations thereof.
In some aspects, the tumor tissue sample is a formalin-fixed and paraffin-embedded (FFPE) sample, an archived sample, a fresh sample, or a frozen sample.
In some aspects, the tumor tissue sample is an FFPE sample.
In some aspects, the cancer is lung cancer, kidney cancer, bladder cancer, breast cancer, colorectal cancer, ovarian cancer, pancreatic cancer, stomach cancer, esophageal cancer, mesothelioma, melanoma, head and neck cancer, thyroid cancer, sarcoma, prostate cancer, glioblastoma, cervical cancer, thymus cancer, leukemia, lymphoma, myeloma, mycosis fungoides, merkel cell carcinoma, or a hematological malignancy.
In some aspects, the cancer is lung cancer, renal cancer, bladder cancer, or breast cancer.
In some aspects, the lung cancer is non-small cell lung cancer (NSCLC).
In some aspects, the NSCLC is non-squamous NSCLC.
In some aspects, the NSCLC is squamous NSCLC.
In some aspects, the benefit comprises a prolongation of OS in the individual, a prolongation of PFS in the individual, and/or an improvement in BCOR in the individual as compared to treatment without the PD-L1 axis binding antagonist.
In some aspects, the benefit comprises a prolongation of OS in the individual as compared to treatment without the PD-L1 axis binding antagonist.
In some aspects, the PD-L1 axis binding antagonist is selected from the group consisting of a PD-L1 binding antagonist, a PD-1 binding antagonist, and a PD-L2 binding antagonist.
In some aspects, the PD-L1 axis binding antagonist is a PD-L1 binding antagonist.
In some aspects, the PD-L1 binding antagonist inhibits the binding of PD-L1 to one or more of its ligand binding partners.
In some aspects, the PD-L1 binding antagonist inhibits the binding of PD-L1 to PD-1.
In some aspects, the PD-L1 binding antagonist inhibits the binding of PD-L1 to B7-1.
In some aspects, the PD-L1 binding antagonist inhibits the binding of PD-L1 to both PD-1 and B7-1.
In some aspects, the PD-L1 binding antagonist is an antibody or antigen-binding fragment thereof.
In some aspects, the antibody is selected from the group consisting of: alemtuzumab, MDX-1105, MEDI4736 (dewaluzumab), and MSB0010718C (avizumab).
In some aspects, the antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
In some aspects, the antibody comprises: a heavy chain variable region comprising the amino acid sequence of SEQ ID NO 7; and a light chain variable region comprising the amino acid sequence of SEQ ID NO 8.
In some aspects, the PD-L1 axis binding antagonist is a PD-1 binding antagonist.
In some aspects, the PD-1 binding antagonist inhibits the binding of PD-1 to one or more of its ligand binding partners.
In some aspects, the PD-1 binding antagonist inhibits the binding of PD-1 to PD-L1.
In some aspects, the PD-1 binding antagonist inhibits the binding of PD-1 to PD-L2.
In some aspects, the PD-1 binding antagonist inhibits the binding of PD-1 to both PD-L1 and PD-L2.
In some aspects, the PD-1 binding antagonist is an antibody or antigen-binding fragment thereof.
In some aspects, the antibody is selected from the group consisting of: MDX-1106 (nivolumab), MK-3475 (pembrolizumab), MEDI-0680 (AMP-514), PDR001, REGN2810, and BGB-108.
In some aspects, the PD-1 binding antagonist is an Fc fusion protein.
In some aspects, the Fc fusion protein is AMP-224.
In some aspects, the subject has not been treated for the cancer.
In some aspects, the subject has not been administered a PD-L1 axis binding antagonist.
In some aspects, the cancer is NSCLC, and wherein the individual does not have EGFR or ALK genomic tumor aberrations.
In some aspects, the subject has been previously treated for the cancer.
In some aspects, the subject has been treated for the cancer by administering to the subject a platinum-containing chemotherapeutic agent, and wherein the subject is non-responsive to the chemotherapeutic agent.
In some aspects, the PD-L1 axis binding antagonist is administered as a monotherapy.
In some aspects, the method further comprises administering an effective amount of one or more additional therapeutic agents.
The one or more additional therapeutic agents include an anti-tumor agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, an immunomodulatory agent, or a combination thereof.
In some aspects, the individual is a human.
In another aspect, the invention features a kit that includes a PD-L1 axis binding antagonist and instructions for administering the PD-L1 axis binding antagonist to an individual who has been identified as an individual who is likely to benefit from treatment comprising the PD-L1 binding antagonist according to any one of the methods disclosed herein.
In another aspect, the invention features a kit that includes a PD-L1 axis binding antagonist and instructions for administering the PD-L1 axis binding antagonist to an individual for whom treatment comprising the PD-L1 binding antagonist has been selected according to any one of the methods disclosed herein.
In another aspect, the invention features a kit for identifying an individual having cancer who is likely to benefit from treatment with a PD-L1 axis binding antagonist, the kit including reagents for determining the expression levels of two or more of the genes CD79A, CD19, BANK1, jchan, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual, wherein the individual is identified as an individual who is likely to benefit from treatment with a PD-L1 axis binding antagonist if the immune score expression levels of the two or more genes are greater than reference immune score expression levels for the two or more genes.
In another aspect, the invention features a kit for identifying an individual having cancer who is likely to benefit from treatment with a PD-L1 axis binding antagonist, the kit including reagents for determining the expression level of one or more of genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual, wherein the individual is identified as an individual who is likely to benefit from treatment with a PD-L1 axis binding antagonist if the immune score expression level of the one or more genes is greater than the reference immune score expression level for the one or more genes, wherein the benefit includes an increase in OS in the individual as compared to treatment without the PD-L1 axis binding antagonist.
In another aspect, the invention features a kit for identifying an individual having cancer who is likely to benefit from treatment with a PD-L1 axis binding antagonist, the kit including reagents for determining the expression level of one or more of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 in a sample from the individual, wherein the benefit comprises an extended OS in the individual as compared to treatment without the PD-L1 axis binding antagonist, where the immune score expression level of the one or more genes is greater than a reference immune score expression level of the one or more genes.
In another aspect, the invention features a PD-L1 axis binding antagonist for use in a method of treating an individual having cancer, the method comprising:
(a) Determining in a sample from the individual the expression level of one or more of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7 and IGLL5, wherein the determination of the immune score expression level of the one or more genes in the sample is higher than the reference immune score expression level of the one or more genes; and
(b) Administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another aspect, the invention features a PD-L1 axis binding antagonist for use in treating cancer in an individual, wherein the individual has been determined to have an immune score expression level of one or more of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 in a sample from the individual that is higher than a reference immune score expression level of the one or more genes.
In another aspect, the invention features a PD-L1 axis binding antagonist for use in a method of treating an individual having cancer, the method comprising:
(a) Determining in a sample from the individual the expression level of one or more of the genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5, wherein determining the immune score expression level of the one or more genes in the sample is higher than a reference immune score expression level of the one or more genes, thereby identifying the individual as an individual who is likely to benefit from treatment comprising a PD-L1 axis binding antagonist, wherein the benefit comprises a prolongation of OS in the individual as compared to treatment without the PD-L1 axis binding antagonist; and
(b) Administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another aspect, the invention features a PD-L1 axis binding antagonist for use in treating cancer in an individual, wherein the individual has been determined to have an immune score expression level of one or more of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 in a sample from the individual that is higher than a reference immune score expression level for the one or more genes, wherein identifying the individual as an individual likely to comprise treatment with the PD-L1 axis binding antagonist would benefit if the immune score expression level of the one or more genes is higher than the reference immune score expression level for the one or more genes, wherein the benefit comprises a prolongation of the individual's OS as compared to treatment without the PD-L1 axis binding antagonist.
In another aspect, the invention features a kit for identifying an individual having cancer who is likely to benefit from treatment with a binding antagonist containing PD-L1 axis, the kit including reagents for determining the presence of Tertiary Lymphoid Structure (TLS) in a tumor sample from the individual, wherein the presence of TLS in the tumor sample identifies the individual as likely to benefit from treatment with a binding antagonist containing PD-L1 axis.
In another aspect, the invention features a kit for identifying an individual having cancer who may benefit from treatment comprising a PD-L1 axis binding antagonist, the kit comprising reagents for determining the expression level of two or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from the individual, wherein the individual is identified as an individual who may benefit from treatment comprising a PD-L1 axis binding antagonist if the immune score expression level of the two or more genes is higher than a reference immune score expression level of the two or more genes.
In another aspect, the invention features a kit for identifying an individual having cancer who is likely to benefit from treatment with a PD-L1 axis binding antagonist, the kit including reagents for determining the number of B cells in a tumor sample from the individual, wherein the individual is identified as an individual who is likely to benefit from treatment with a PD-L1 axis binding antagonist if the number of B cells in the tumor sample is greater than a reference number of B cells.
In another aspect, the invention features a kit for identifying an individual having cancer who is likely to benefit from treatment with a PD-L1 axis binding antagonist, the kit including reagents for determining whether the individual has clonally expanded B cells in a tumor sample from the individual, wherein the clonally expanded B cells in the sample identify the individual as an individual who is likely to benefit from treatment with a PD-L1 axis binding antagonist.
Drawings
Figures 1A to 1C show that B-cell gene signature and CD79A are associated with atuzumab-mediated survival benefit in the POPLAR 2 phase study. FIG. 1A: differential gene expression analysis, showing enrichment of B cell gene signatures when comparing patients with OS ≤ 6 months (n = 24) to OS ≥ 12 months (n = 43). Yellow circles indicate B cell gene transcripts, and red circles indicate T eff A gene transcript. Kaplan Meier (KM) curves comparing the probability of survival (n = 194) for patients with enriched (fig. 1B) B cell gene profiles (greater than median docetaxel patients =11.07 months, less than median docetaxel patients =9.23 months, less than median alemtuzumab patients =8.44 months) and (fig. 1C) CD79A genes (greater than median docetaxel patients =12.45 months, less than median docetaxel patients =9.23 months, less than median alemtuzumab patients =8.44 months).
Figures 2A to 2D show that patients with high B-cell gene signatures correlated with atuzumab-induced tumor responses in multiple phase 3 studies. KM curve comparing survival probability of patients with B-cell-rich gene profiles (both high (greater than median) and low (less than median), as shown): in the OAK trial (fig. 2A) (n = 727), the median greater docetaxel group patients =12.39 months, the median less docetaxel group patients =8.8 months, the median greater attritumab group patients =18.04 months, the median less attritumab group patients =7.79 months); and in (fig. 2B) BIRCH trial (n = 591), greater than median attrituximab group patients =17.74, less than median attritumab group patients =14.09 months. FIG. 2C: comparison of BCORs of patients with enriched B cell gene profiles in the docetaxel and alemtuzumab groups in the patient population was classified as Complete Remission (CR), partial Remission (PR), progressive Disease (PD), stable Disease (SD) according to RECIST V1.1 classification criteria. The p-value for docetaxel group was 0.34 and for alemtuzumab group was 0.00094 (Kruskal-Wallis test). FIG. 2D: progression Free Survival (PFS) profile in OAK trial (n = 727) (median greater docetaxel =4.17 months, median less docetaxel =2.83 months, median greater alemtuzumab =2.99 months, median less alemtuzumab =1.64 months).
Figures 3A to 3E show that patients responding to altlizumab have B cells and TLS infiltrated into the tumor, which appears to be associated with survival benefit. FIG. 3A: immunofluorescence representative images of pre-treatment lung adenocarcinoma samples showed high B cell gene profiles and were classified as atuzumab responders: CD79A is shown in green, CD8 in red, and Ki67 in blue. Scale bar: 100mm. FIG. 3B: representative H & E staining of lung adenocarcinoma from patients who responded to atuzumab showed the presence of TLS, as indicated by the marker. Scale bar: 500mm. FIG. 3C: correlation of CD79a gene expression, comparing patient tissues showing the presence or absence of TLS (. About.. P <0.001, paired t-test). FIG. 3D: correlation of CD3D gene expression, patient tissues showing the presence or absence of TLS were compared (.: p <0.01, paired t-test). FIG. 3E: in the POPLAR assay, the overall survival (in months) of the docetaxel and alemtuzumab groups correlated with the presence/absence of TLS (: p <0.05, paired t-test) (n = 194).
FIGS. 4A to 4D show immunostaining of TLS. Representative images of IHC from lung adenocarcinoma tissue of patients exhibiting high B cell gene signature and classified as attrituzumab responders, showing (fig. 4A) hematoxylin and eosin (H & E) staining in the presence of TLS (as shown by white circles), (fig. 4B) panCK and CD8 (red) staining, (fig. 4C) PNAd (peripheral lymph node addressen) (fig. 4D) CD40 staining. The scale bar is 20 μm.
Fig. 5A to 5D are KM curves comparing the survival probability of patients with enriched TLS gene characteristics: (fig. 5A) in the POPLAR trial (n = 194), greater than median docetaxel patients =10.63 months, less than median docetaxel patients =9.9 months, greater than median alemtuzumab patients =15.47 months, less than median alemtuzumab patients =8.54 months; and (figure 5B) in the OAK trial (n = 727), the median greater docetaxel group patients =10.28 months, the median less docetaxel group patients =10.28 months, the median greater attritumab group patients =14.32 months, the median less attritumab group patients =11.76 months. KM curves comparing survival probability of patients with enriched germinal center gene characteristics: (fig. 5C) in the POPLAR trial (n = 194), patients with greater than median docetaxel =8.87 months, less than median docetaxel =10.05 months, less than median alemtuzumab =9.72 months; and (fig. 5D) in the OAK trial (n = 727), the median greater docetaxel group patients =11.43 months, the median less docetaxel group patients =8.9 months, the median greater attritumab group patients =16.26 months, the median less attritumab group patients =9.95 months.
Fig. 6A to 6E show that patients who obtained the alemtuzumab-mediated benefit are enriched for B cell lineages. FIG. 6A: KM curves comparing the probability of survival (n = 727) for patients with plasma B cell 2-gene signature (median docetaxel =11.07 months, median less docetaxel =9.53 months, median greater alemtuzumab =16.43 months, median less alemtuzumab =7.82 months). BCR sequencing was done from limited patient samples (as shown), where the diversity of clonality was shown using shannon index: (fig. 6B) control patients (n = 3); (fig. 6C) PR (red) and SD (blue) patients prior to atlizumab treatment (n = 8); (fig. 6D) PD patients (n = 3), and a summary graph showing the change in shannon index (fig. 6E) is displayed.
Fig. 7 shows the enrichment of genes in the POPLAR assay and provides a list of genes enriched by the atuzumab responders and their HR and p values.
Fig. 8A and 8B show the association of B cells with PD-L1 status. A graph quantifying the association of B cell gene signatures with (fig. 8A) immune cell PD-L1 levels, where IC0=0%, IC1=1% to 5%, IC2=5% to 49%, IC3=50% or more (fig. 8B) immunity and tumor cell PD-L1 were determined by SP142 PD-L1 assay (Wilcoxon paired analysis).
FIGS. 9A to 9F showTLS prevalence and its association are shown. FIG. 9A: histology-based distribution of TLS (containing germinal centers) and lymphatic aggregates (no germinal centers). FIG. 9B: distribution of TLS in biopsy and resection samples. TLS presence identified by IHC and RNA sequencing-based (FIG. 9C) B cells, (FIG. 9D) T eff And (FIG. 9E) association of genetic signatures of TLS (Wilcoxon paired analysis). FIG. 9F: association of overall survival (in months) of docetaxel and attrituximab groups with presence/absence of TLS in OAK assay (. About.. P:. Sup.)<0.001, paired t-test).
Fig. 10A to 10D show the association of B cell and TLS gene signatures with other biomarkers. Graphs quantifying the association of B cell characteristics with (fig. 10A) Tumor Mutation Burden (TMB) and (fig. 10B) STK11 mutation status. Graph showing the association of TLS gene signature with (fig. 10C) TMB and (fig. 10D) STK11 mutation status (Wilcoxon pairwise analysis).
Fig. 11A to 11C show the association of survival benefit with B cell immunophenotype. KM curves comparing the probability of survival for patients enriched in (n = 727): (fig. 11A) initial B-cell gene signature, greater than median docetaxel =10.71 months, less than median docetaxel =9.9 months, greater than median alemtuzumab =13.47 months, less than median alemtuzumab =11.79 months; (figure 11B) memory B cell characteristics, greater than median docetaxel =12.39 months, less than median docetaxel =8.8 months, greater than median alemtuzumab =17.64 months, less than median alemtuzumab =8.9 months; and (fig. 11C) plasma B cells, median greater docetaxel patients =11.53 months, median less docetaxel patients =9.72 months, median greater alemtuzumab patients =15.49 months, and median less alemtuzumab patients =9.72 months.
Fig. 12A to 12E show the enrichment of IgG subtype plasma cells in the atezumab responder. FIG. 12A shows% IgG; FIG. 12B shows the ratio of IgG to IgM; figure 12C shows% IgM; FIG. 12D shows the relative amounts of IgG compared to total IgG and IgM content; and figure 12E shows% IgA. BCR sequencing of different Ig domains compiled from limited patient samples, patients were classified as PR (brown), SD (blue) and PD (red) patients according to RECIST v1.1 before and after atuzumab treatment (n = 17).
Fig. 13A to 13D show the association of survival benefit with B cell immunophenotype. KM curves, comparing survival probabilities for patients enriched for: (fig. 13A) in the OAK trial, enriched for T cell effector gene signature and CD79A, with greater than median docetaxel =12.97 months, less than median docetaxel =9.12 months, greater than median alemtuzumab =15.9 months, less than median alemtuzumab =9.48 months; (fig. 13B) in the POPLAR trial, enriched for T cell effector gene signature and CD79A, with greater than median docetaxel =9.63 months, less than median docetaxel =9.35 months, less than median alemtuzumab =8.54 months; (figure 13C) enriched for T cell effector gene signature in OAK trial, with greater than median docetaxel patients =11.1 months, less than median docetaxel patients =9.82 months, greater than median alemtuzumab patients =15.34 months, less than median alemtuzumab patients =10.12 months; and (fig. 13D) enriched for T cell effector gene signature in the POPLAR trial with greater than median docetaxel patients =9.72 months, less than median docetaxel patients =9.23 months, greater than median alemtuzumab patients =15.47 months, less than median alemtuzumab patients =9.72 months.
Fig. 14A to 14C show that the association of B cell characteristics with OS benefit is consistent in the major subgroups. In the major subgroup, B cell signature was highly correlated with atlizumab-mediated OS benefit: (FIG. 14A) squamous vs non-squamous, (FIG. 14B) biopsy vs resection, and (FIG. 14C) lung tumor vs lymph node metastasis.
Fig. 15A to 15G show that intratumoral B cells were associated with increased OS in NSCLC patients receiving treatment with astuzumab. (FIG. 15A) shows volcano plots of differentially expressed genes (FDR P <0.05, absolute logFC ≧ 0.5) between patients with <6 months of OS from OAK (n = 205) and patients with >12 months of OS (n = 205) after treatment with atuzumab. (fig. 15B) same as fig. 15A, in patients receiving treatment with docetaxel. (FIGS. 15C to 15F) Kaplan Meier (KM) curves comparing the survival probability of patients enriched with CD79A, CD19, IFNG and the IFN-inducible chemokine CXCL 10. Gene expression was classified as high (upper T3 triplet) or low/medium (T1 and T2 triplet). (FIG. 15G) representative immunofluorescence images of pre-treatment lung adenocarcinoma tumors from two patients who responded to atuzumab (left panel) and two patients who did not respond to atuzumab. (scale bar: 100 μm).
Fig. 16A to 16D show the identification of three B-cell subsets in NSCLC tumors. (FIG. 16A) left: UMAP dimensionality reduction of 20,362 cells (spots). The same UMAP is given in the upper right corner. Right lower: from metastatic lymph nodes (mLN), non-metastatic lymph nodes (nLN), normal adjacent lung tissue (nlong), tumor biopsy (Tbio), and tumor resection (T res) in each cluster. Bottom center: relative mean expression of markers shown in the clusters of figure 16A. (FIG. 16B) left: the cell fraction (row) for each patient of the cluster given in fig. 16A. Right side: absolute cell numbers per patient in clusters in fig. 16A. (FIG. 16C) Violin diagram showing expression of marker genes in the cluster of FIG. 16A. (FIG. 16D) UMAP from B cell subsets of six purchased fresh NSCLC tumor samples, analyzed by CyTOF, recapitulated the presence of follicular B cells (HLA-DR +, CD 38-), germinal Center (GC) B cells (HLA-DR +, CD38+ Ki67 +) and plasma cells (HLA-DR-, CD38+ +).
Figures 17A and 17B show B cell subpopulation characteristics in batch RNAseq spectra. (FIG. 17A) hierarchical clustering of three B-cell features identified in OAK from scRNA-seq data. (FIG. 17B) scatter plot showing correlation between plasma cell, germinal center B cell and follicular B cell characteristics. Pearson R values are reported.
Figures 18A to 18F show that plasma cell characteristics independently predict response to atuzumab. (FIGS. 18A to 18C) Kaplan-Meier curves for OS for each of the three characteristics, divided into T3 (upper triplet) and T1-T2 (lower/middle triplet). Log rank p values are reported. (FIG. 18D) heatmap, showing the results of a Cox proportional hazards model that examines the risk ratio within and between groups. Dots represent statistically significant HR (p < 0.05). (fig. 18E) forest plot showing the significance of three B cell features and the previously reported 8 gene T effector feature (tGE 8) in the univariate interaction model, taking into account the interaction between the feature score and the treatment groups. (fig. 18F) forest plot showing the significance of the four features shown in fig. 18E in the multivariate analysis of the alemtuzumab group (left panel) and the docetaxel group (right panel). In all models, the features were classified as T3 and T1-T2.
Figures 19A to 19C show that patients with TLS/LA + tumors showed improved OS for treatment with atuzumab. (fig. 19A) H & E staining showing tumors with tertiary lymphoid structures (TLS, left panel), only lymphoid aggregates (middle panel), or neither (right panel) in representative samples from POPLAR. (fig. 19B) bar graph depicting the proportion of tumors with TLS, lymph Aggregate (LA) only, or neither in each treatment group in POPLAR. (FIG. 19C) Kaplan-Meier curve representing OS for tumors with TLS or LA and tumors without both given by treatment group.
FIGS. 20A to 20C show plasma cell TLS/LA + enriched tumors. (FIG. 20A) hierarchical clustering of three B-cell subpopulation characteristics. Samples were ordered by TLS/LA status. (FIG. 20B) volcano plots depicting differentially expressed genes between tumors with TLS and/or LA and tumors without both. Genes from three B cell characteristics are highlighted. (FIG. 20C) Violin plot showing characteristic z-scores of plasma cells, germinal center B cells and follicular B cells, grouped by TLS/LA status. Mann-Whitney p values are reported.
Fig. 21A to 21F provide more information about the data shown in fig. 15A to 15G. (FIG. 21A) shows volcanograms of differentially expressed genes (FDR P <0.05, absolute logFC ≧ 0.5) between patients from OAK with POPLAR <6 months (n = 58) and patients with OS >12 months (n = 87) after treatment with atuzumab. (fig. 21B) same as fig. 21A, in patients receiving treatment with docetaxel. (FIGS. 21C to 21F) Kaplan Meier (KM) curves comparing the survival probability of patients enriched with CD79A, CD19, IFNG and the IFN-inducible chemokine CXCL 10. Gene expression was classified as high (upper T3 triplet) or low/medium (T1 and T2 triplet).
Fig. 22A and 22B provide more information about the data shown in fig. 16A through 16D. (FIG. 22A) expression of putative signature genes of follicular B cells, plasma cells and GC B cells in non-B cell scRNA-seq compartments. Candidate markers for global deconvolution are highlighted, indicating the reason for the removal of the signature genes due to the global high background. (FIG. 22B) UMAP projection of scRNA-seq expression in B cells, depicting follicular B cells, plasma cells and GC B cells, summarizing CyTOF results for follicular B cells (HLA-DR +, CD 38-), germinal Center (GC) B cells (HLA-DR +, CD38+ Ki67 +) and plasma cells (HLADR-, CD38+ +).
FIG. 23 is the Pearson correlation of B cell subset signature genes in all samples in OAK, as described in example 1 below.
Fig. 24A through 24E provide more information about fig. 18A through 18F. (FIG. 24A) dichotomized plasma cell feature scores for three-level stratification for best overall remission within each group as objective remission or persistent stable disease (SD with PFS > 6 months) versus progressive disease or non-persistent stable disease (SD with PFS <6 months). The p value was Fisher's exact test. (FIGS. 24B to 24D) Kaplan-Meier curves for OS for each of the three features, divided into T3 (upper third) and T1-T2 (lower/middle third). Log rank P values are reported. (FIG. 24E) Kaplan-Meier curves for OS characteristic of plasma cells, divided into T3 and T1-2 in TCGA 365LUAD/LUSC data. The risk ratio and associated P-value for the overall survival period, which is characteristic of plasma cells, are shown.
Detailed Description
The present disclosure provides diagnostic methods, therapeutic methods, and compositions for treating cancer, e.g., lung cancer (e.g., non-small cell lung cancer (NSCLC)), bladder cancer (e.g., urothelial Cancer (UC)), kidney cancer (e.g., renal Cell Carcinoma (RCC)), and breast cancer (e.g., triple Negative Breast Cancer (TNBC)).
The present disclosure is based, at least in part, on the following findings: one or more of the biomarkers disclosed herein, e.g., the presence and/or expression level of any of the genes listed in any one of tables 1 to 17, the presence and/or expression level of a B cell characteristic (e.g., a plasma B cell characteristic), the presence of a Tertiary Lymphoid Structure (TLS), the presence and/or expression level of a TLS characteristic, the presence and/or number of B cells and/or the presence and/or of clonally expanded B cells, can be used to identify and select individuals who may benefit from treatment with a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., attritumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
For example, as described in example 1 below, the present disclosure demonstrates that elevated expression levels of CD79A and other B cell signature genes, including plasma B cell signature genes, correlate with improved Overall Survival (OS) in NSCLC patients receiving treatment with the anti-PD-L1 antibody, atuzumab. Similarly, the presence of Tertiary Lymphoid Structures (TLS) and elevated expression levels of TLS signature genes are also associated with improved OS in NSCLC patients receiving treatment with the anti-PD-L1 antibody atelizumab. Thus, the biomarkers disclosed herein can be used, for example, to identify individuals who may benefit from treatment with a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attritumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)), to select an optimized cancer therapy for a patient, and to provide personalized treatment methods for patients who may benefit.
I. Definition of
The term "about" as used herein refers to the usual range of error for the corresponding value as readily known to those of skill in the art. References herein to "about" a value or parameter include (and describe) embodiments that refer to the value or parameter itself.
As used herein, "administering" means a method of administering to a subject a dose of a compound (e.g., a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as alemtuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) or composition (e.g., a pharmaceutical composition, such as a pharmaceutical composition comprising a PD-L1 axis binding antagonist compound and/or composition used in the methods described herein can be administered, for example, intravenously (e.g., by intravenous infusion), subcutaneously, intramuscularly, intradermally, transdermally, intraarterially, intraperitoneally, intralesionally, intracranially, intraprostatally, intrapleurally, intratracheally, intranasally, intravitreally, intravaginally, intrarectally, topically, intratumorally, subconjunctivally, intravesicularlly, intracapsularly, mucosally, intraperically, intraoccularly, intraocularly, orally, topically, by inhalation, by injection, by infusion, by continuous infusion, by direct bathing target cells, by a catheter, by lavage, in a variety of the composition, or the disease condition to be treated, and the method to be treated.
"affinity" refers to the strength of the sum of non-covalent interactions between a single binding site of a molecule (e.g., an antibody) and its binding partner (e.g., an antigen). As used herein, unless otherwise specified, "binding affinity" refers to intrinsic binding affinity that reflects a 1. The affinity of a molecule X for its partner Y can generally be determined by the dissociation constant (K) D ) And (4) showing. Affinity can be measured by conventional methods known in the art, including those described herein. Specific illustrative and exemplary embodiments for measuring binding affinity are described below.
An antibody that is "affinity matured" refers to an antibody that has one or more alterations in one or more hypervariable regions (HVRs) that result in an improvement in the affinity of the antibody for an antigen compared to a parent antibody that does not have such alterations.
"amplification" as used herein generally refers to the process of producing multiple copies of a desired sequence. "multicopy" means at least two copies. "copy" does not necessarily mean perfect sequence complementarity or identity to the template sequence. For example, the copies may include nucleotide analogs, such as deoxyinosine, intentional sequence alterations (e.g., sequence alterations introduced by primers comprising sequences that are hybridizable, but not complementary, to the template), and/or sequence errors that occur during amplification.
The term "antibody" is used herein in the broadest sense and includes a variety of antibody structures, including, but not limited to, monoclonal antibodies, polyclonal antibodies, multispecific antibodies (e.g., bispecific antibodies), and antibody fragments, so long as they exhibit the desired antigen-binding activity.
An "antibody fragment" refers to a molecule other than an intact antibody that comprises a portion of an intact antibody and binds to an antigen to which the intact antibody binds. Examples of antibody fragments include, but are not limited to, fv, fab '-SH, F (ab') 2 (ii) a A diabody; a linear antibody; single chain antibody molecules (e.g., scFv); and multispecific antibodies formed from antibody fragments.
An "antibody that binds to the same epitope" as a reference antibody refers to an antibody that blocks binding of the reference antibody to its antigen by 50% or more in a competition assay, whereas a reference antibody blocks binding of the antibody to its antigen by 50% or more in a competition assay. An exemplary competition assay is provided herein.
The terms "anti-PD-L1 antibody" and "antibody that binds to PD-L1" refer to an antibody that is capable of binding to PD-L1 with sufficient affinity such that the antibody is useful as a diagnostic and/or therapeutic agent targeting PD-L1. In one embodiment, the anti-PD-L1 antibody binds to an unrelated, non-PD-L1 protein to less than about 10% of the extent of binding of the antibody to PD-L1, as measured, for example, by a Radioimmunoassay (RIA). In certain embodiments, the anti-PD-L1 antibody binds to an epitope of PD-L1 that is conserved among PD-L1 from different species. In certain embodiments, the anti-PD-L1 antibody is atelizumab. PD-L1 (programmed death ligand 1) is also known in the art as "programmed cell death 1 ligand 1", "PDCD1LG1", "CD274", "B7-H", and "PDL1". An exemplary human PD-L1 is shown in UniProtKB/Swiss-Prot accession number Q9NZQ7.1.
The term "anti-cancer therapy" refers to a therapy for treating cancer (e.g., lung cancer (e.g., non-small cell lung cancer (NSCLC), including non-squamous NSCLC and squamous NSCLC), bladder cancer (e.g., urothelial Cancer (UC)), renal cancer (e.g., renal Cell Carcinoma (RCC)), or breast cancer (e.g., triple-negative breast cancer (TNBC)))And (4) treating. Examples of anti-cancer therapeutic agents include, but are not limited to, e.g., PD-L1 axis binding antagonists (e.g., PD-L1 binding antagonists (e.g., anti-PD-L1 antibodies, such as alemtuzumab) or PD-1 binding antagonists (e.g., anti-PD-1 antibodies)), chemotherapeutic agents, growth inhibitors, cytotoxic agents, agents used in radiotherapy, anti-angiogenic agents, apoptotic agents, anti-tubulin agents, and other agents for treating cancer (e.g., anti-CD 20 antibodies), platelet-derived growth factor inhibitors (e.g., GLEEVEC) TM (imatinib mesylate)), COX-2 inhibitors (e.g., celecoxib), interferons, cytokines, antagonists (e.g., neutralizing antibodies) that bind to one or more of the following targets: PDGFR-beta, bl gamma S, APRIL, BCMA receptor, TRAIL/Apo2, other biologically active and organic chemical reagents, and the like. Combinations thereof are also included in the present invention.
An "article of manufacture" or "kit" as used interchangeably herein refers to any article of manufacture (e.g., package or container) or kit comprising at least one agent, e.g., a drug for treating a disease or condition (e.g., cancer, e.g., lung cancer (e.g., NSCLC, including non-squamous NSCLC and squamous NSCLC), bladder cancer (e.g., UC), renal cancer (e.g., RCC), or breast cancer (e.g., TNBC)), or a probe (e.g., a nucleic acid probe or antibody) for specifically detecting a biomarker described herein. In certain embodiments, the article of manufacture or kit is marketed, distributed, or sold as a means for performing the methods described herein.
The phrase "based on" as used herein means that information about one or more biomarkers is used to inform information provided on treatment decisions, package inserts or marketing/promotional guidelines, etc.
The term "B cell" as used herein refers to a lymphocyte that matures within the bone marrow and includes, but is not limited to, naive B cells, memory B cells, or plasma B cells (also referred to as plasma cells or effector B cells). B cells are also known in the art as "B lymphocytes". Unlike other lymphocytes such as T cells or natural killer cells, B cells can express a B Cell Receptor (BCR) on their plasma membrane.
The "B cell receptor" or "BCR" is a transmembrane receptor complex located on the B cell plasma membrane. BCRs include membrane-bound immunoglobulin (mIgG) moieties (e.g., mIgA, mIgG, mIgM, or mIgD) and signal transduction moieties composed of CD79A/CD79B heterodimers (also referred to as Ig- α/Ig- β). Each member of the CD79A/CD79B heterodimer spans the plasma membrane and includes a cytoplasmic tail that includes an immunoreceptor tyrosine-based activation motif (ITAM).
A "blocking" antibody or "antagonist" antibody is an antibody that inhibits or reduces the biological activity of the antigen to which it binds. Preferred blocking or antagonist antibodies substantially or completely inhibit the biological activity of the antigen.
"binding domain" refers to a portion of a compound or molecule that specifically binds to a target epitope, antigen, ligand, or receptor. Binding domains include, but are not limited to, antibodies (e.g., monoclonal, polyclonal, recombinant, humanized, and chimeric), antibody fragments, or portions thereof (e.g., fab fragment, fab' 2 scFv antibodies, SMIPs, domain antibodies, diabodies, minibodies, scFv-Fc, affibodies, nanobodies, and VH and/or VL domains of antibodies), receptors, ligands, aptamers, and other molecules with identified binding partners.
The term "biomarker" as used herein refers to an indicator that can be detected in a sample, such as a predictive, diagnostic, and/or prognostic indicator (e.g., any gene listed in any one of tables 1-17, such as one or more of CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, MZB1, CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, CXCL13, DERL3, JSRP1, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, and IGLC 7). Biomarkers can be used as indicators of particular subtypes of a disease or disorder (e.g., cancer, such as lung cancer (e.g., NSCLC, including non-squamous NSCLC and squamous NSCLC), bladder cancer (e.g., UC), renal cancer (e.g., RCC), or breast cancer (e.g., TNBC)) characterized by particular molecular, pathological, histological, and/or clinical features. In some embodiments, the biomarker is a gene. Biomarkers include, but are not limited to, polynucleotides (e.g., DNA and/or RNA), polynucleotide copy number alterations (e.g., DNA copy number), polypeptides and polynucleotide modifications (e.g., post-translational modifications), carbohydrates, glycolipid-based molecular markers, cells (e.g., B cells), and/or histological structures (e.g., tertiary lymphoid structures).
The terms "biomarker signature," "biomarker expression signature," or "expression signature" are used interchangeably herein and refer to the level of immune expression of one or a combination of biomarkers (e.g., any of the genes listed in any one of tables 1-17 (e.g., CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, MZB1, CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, jscl 9, CXCL10, CXCL11, CXCL13, DERL3, crp 1, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, and IGLC 7)) whose expression is an indicator (e.g., predictive, diagnostic, and/or prognostic indicator). Biomarker signatures can be used as indicators of particular subtypes of a disease or disorder (e.g., cancer, such as lung cancer (e.g., NSCLC, including non-squamous NSCLC and squamous NSCLC), bladder cancer (e.g., UC), renal cancer (e.g., RCC), or breast cancer (e.g., TNBC)) characterized by particular molecular, pathological, histological, and/or clinical features. In some embodiments, the biomarker signature is a "genetic signature". The term "gene signature" is used interchangeably with "gene expression signature" and refers to one or a combination of polynucleotides whose expression is an indicator (e.g., a predictive, diagnostic, and/or prognostic indicator). The gene signature may be, for example: b cell gene signatures (e.g., one or more of genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and/or MZB 1), initial B cell gene signatures (e.g., one or more of genes ABCB4, BCL7A, BEND5, BRAF, IL4R, LINC00921, MEP1A, MICAL3, NIPSNAP3B, PSG2, SELL, TCL1A, UGT1A8, and/or ZNF 286A), memory B cell gene signatures (e.g., one or more of the genes AIM2, ALOX5, CLCA3P, FAM65B, IFNA10, IL7, NPIPB15, SP140, TNFRSF13B, TRAF4, and/or ZBTB 32), plasma cell gene signature (e.g., one or more of the genes DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and/or IGLL5, and/or one or more of the genes ABCB9, AMPD1, ANGPT4, ATXN8OS, C11, CCr10, HIST1H2AE, HIST1H2BG, IGHE, KCNA3, KCNG2, LOC100130100, MAN1A1, MANEA, MAST1, MROH7, MZB1, PAX7, PDK1, RASGRP3, REN, SPAG4, ST6GAL 4, TGM5, UGT2B17, ZBP1, and/or ZNF 16), a characteristic of a T effector (e.g., one or more of the genes CCL2, CCL3, CCL4, NAC 5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and/or CXCL 13) or a sub-characteristic of a T effector (e.g., one or more of the genes CD8A, TLMES, GZMA, TBX21, IFNG, CXCL9, CXCL11, and/or CXCL 10). In some embodiments, the biomarker signature is a "protein signature. The term "protein characteristic" is used interchangeably with "protein expression characteristic" and refers to one or a combination of polypeptides whose expression is an indicator (e.g., a predictive, diagnostic, and/or prognostic indicator).
The term "CD79A" as used herein, unless otherwise indicated, refers to a cluster of differentiated CD79A genes, including any native CD79A from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). CD79A is also known in the art as Ig- α, B cell antigen receptor complex associated protein α chain and MB-1 membrane glycoprotein. The term encompasses "full-length" unprocessed CD79A, as well as any form of CD79A resulting from processing in a cell. The term also encompasses naturally occurring variants of CD79A, such as splice variants or allelic variants. The nucleic acid sequence of exemplary human CD79A is set forth in SEQ ID NO 13 (NCBI reference: NM-001783.4). The amino acid sequence of an exemplary protein encoded by human CD79A is shown in SEQ ID NO 14 (UNIPROT) TM Accession number P11912-1).
The term "SLAMF7" as used herein, unless otherwise indicated, refers to any native SLAMF7 (signaling lymphocyte activating molecule (SLAM) family member) from any vertebrate source7) The vertebrate source includes mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). The term encompasses "full-length" unprocessed SLAMF7, as well as any form of SLAMF7 that results from processing in the cell. The term also encompasses naturally occurring variants of SLAMF7, such as splice variants or allelic variants. The nucleic acid sequence of an exemplary human SLAMF7 is set forth in SEQ ID NO:15 (NCBI reference sequence: NM-021181.5). The amino acid sequence of an exemplary protein encoded by human SLAMF7 is shown in SEQ ID NO 16 (UNIPROT) TM Accession number Q9NQ 25-1).
The term "BTK" as used herein, unless otherwise indicated, refers to any native BTK (Bruton tyrosine protein kinase) from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). The term encompasses "full-length" unprocessed BTK, as well as any form of BTK that results from processing in a cell. The term also encompasses naturally occurring variants of BTK, such as splice variants or allelic variants. The nucleic acid sequence of an exemplary human BTK is set forth in SEQ ID NO:17 (NCBI reference sequence: NM-000061.2). The amino acid sequence of an exemplary protein encoded by human BTK is shown in SEQ ID NO 18 (UNIPROT) TM Accession number Q06187-1).
The term "TNFRSF17" as used herein, unless otherwise indicated, refers to any native TNFRSF17 (tumor necrosis factor receptor superfamily member 17) from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). TNFRSF17 is also known in the art as B Cell Maturation Antigen (BCMA). The term encompasses "full-length" unprocessed TNFRSF17, as well as any form of TNFRSF17 resulting from processing in a cell. The term also encompasses naturally occurring variants of TNFRSF17, such as splice variants or allelic variants. The nucleic acid sequence of exemplary human TNFRSF17 is set forth in SEQ ID NO 19 (NCBI reference: NM-001192.3). The amino acid sequence of an exemplary protein encoded by human TNFRSF17 is shown in SEQ ID NO:20 (UNIPROT) TM Accession number Q02223-1).
The term "IGJ" as used herein, unless otherwise indicated, refers to any native IGJ (immunoglobulin J chain) from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). The term includes "full-length" unprocessed IGJ, as well as any form of IGJ produced by processing in a cell. The term also encompasses naturally occurring variants of IGJ, such as splice variants or allelic variants. The nucleic acid sequence of an exemplary human IGJ is set forth in SEQ ID NO:21 (NCBI reference sequence: NM-144646.4). The amino acid sequence of an exemplary protein encoded by human IGJ is shown in SEQ ID NO 22 (UNIPROT) TM Accession number P01591-1).
The term "IGLL5" as used herein, unless otherwise indicated, refers to any native IGLL5 (immunoglobulin lambda-like polypeptide 5) from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). IGLL5 is also known in the art as IGL, IGLV, and VL MAR. The term encompasses "full-length" unprocessed IGLL5, as well as any form of IGLL5 that results from processing in a cell. The term also encompasses naturally occurring variants of IGLL5, such as splice variants or allelic variants. The nucleic acid sequence of exemplary human IGLL5 is set forth in SEQ ID NO:23 (NCBI reference sequence: NM-001178126.2). The amino acid sequence of an exemplary protein encoded by human IGLL5 is shown in SEQ ID NO 24 (UNIPROT) TM Accession number B9A 064-1).
The term "RBPJ" as used herein, unless otherwise indicated, refers to any native RBPJ (recombinant signal binding protein of immunoglobulin kappa J region) from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). RBPJ is also known in the art as CBF1 and hairless recombinant binding protein inhibitor. The term encompasses "full-length" unprocessed PRBJs, as well as any form of RBPJ resulting from processing in a cell. The term also encompasses naturally occurring variants of RBPJ, such as splice variants or allelic variants. Core of an exemplary human RBPJThe sequence is set forth in SEQ ID NO. 25 (NCBI reference sequence: NM-005349.3). The amino acid sequence of an exemplary protein encoded by human RBPJ is shown in SEQ ID NO 26 (UNIPROT) TM Accession number Q06330-1).
The term "MZB1" as used herein, unless otherwise indicated, refers to any native MZB1 (marginal zone B and B1 cell-specific proteins) from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). MZB1 is also known in the art as MEDA-7, PACAP, and pERp1. The term encompasses "full-length" unprocessed MZB1, as well as any form of MZB1 that results from processing in the cell. The term also encompasses naturally occurring variants of MZB1, such as splice variants or allelic variants. The nucleic acid sequence of an exemplary human MZB1 is set forth in SEQ ID NO:27 (NCBI reference: NM-016459.4). The amino acid sequence of an exemplary protein encoded by human MZB1 is shown in SEQ ID NO 28 (UNIPROT) TM Accession number Q8WU 39-1).
The term "CCL2" as used herein, unless otherwise indicated, refers to any native CCL2 (chemokine (C-C motif) ligand 2) from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). CCL2 is also known in the art as monocyte chemotactic protein 1 (MCP 1) and small inducible cytokine A2. The term encompasses "full-length" unprocessed CCL2, as well as any form of CCL2 that results from processing in a cell. The term also encompasses naturally occurring variants of CCL2, such as splice variants or allelic variants. The nucleic acid sequence of exemplary human CCL2 is set forth in SEQ ID NO:29 (NCBI reference sequence: NM-002982.4). The amino acid sequence of an exemplary protein encoded by human CCL2 is shown in SEQ ID NO 30 (UNIPROT) TM Accession number P13500-1).
The term "CCL3" as used herein, unless otherwise indicated, refers to any native CCL3 (chemokine (C-C motif) ligand 3) from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). CCL 3 is also known in the art as macrophage inflammatory protein 1-alpha (MIP-1-alpha). The term encompasses "full-length" unprocessed CCL3, as well as any form of CCL3 that results from processing in a cell. The term also encompasses naturally occurring variants of CCL3, such as splice variants or allelic variants. The nucleic acid sequence of an exemplary human CCL3 is set forth in SEQ ID NO:31 (NCBI reference: NM-002983.3). The amino acid sequence of an exemplary protein encoded by human CCL3 is shown in SEQ ID NO 32 (UNIPROT) TM Accession number P10147-1).
The term "CCL4" as used herein, unless otherwise indicated, refers to any native CCL4 (chemokine (C-C motif) ligand 4) from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). CCL4 is also known in the art as macrophage inflammatory protein 1-beta (MIP-1-beta). The term encompasses "full-length" unprocessed CCL4, as well as any form of CCL4 that results from processing in a cell. The term also encompasses naturally occurring variants of CCL4, such as splice variants or allelic variants. The nucleic acid sequence of exemplary human CCL4 is set forth in SEQ ID NO:33 (NCBI reference sequence: NM-002984.4). The amino acid sequence of an exemplary protein encoded by human CCL4 is shown in SEQ ID NO 34 (UNIPROT) TM Accession number P13236-1).
The term "CCL5" as used herein, unless otherwise indicated, refers to any native CCL5 (chemokine (C-C motif) ligand 5) from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). CCL5 is also known in the art as modulating activating normal T cell expression secretion factors (RANTES), SCYA5, SIS- δ, SISd, TCP228, and eoCP. The term encompasses "full-length" unprocessed CCL5, as well as any form of CCL5 that results from processing in a cell. The term also encompasses naturally occurring variants of CCL5, such as splice variants or allelic variants. The nucleic acid sequence of exemplary human CCL5 is set forth in SEQ ID NO:35 (European nucleotide archive accession number AF 043341.1). The amino acid sequence of an exemplary protein encoded by human CCL5 is shown in SEQ ID NO 36 (UNIPROT) TM Accession number P13501-1).
The term "CCL8" as used herein, unless otherwise indicated, refers to any native CCL8 (chemokine (C-C motif) ligand 8) from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). CCL8 is also known in the art as monocyte chemotactic protein 2 (MCP 2). The term encompasses "full-length" unprocessed CCL8, as well as any form of CCL8 that results from processing in a cell. The term also encompasses naturally occurring variants of CCL8, such as splice variants or allelic variants. The nucleic acid sequence of exemplary human CCL8 is set forth in SEQ ID NO:37 (NCBI reference sequence: NM-005623.3). The amino acid sequence of an exemplary protein encoded by human CCL8 is shown in SEQ ID NO 38 (UNIPROT) TM Accession number P80075-1).
The term "CCL18" as used herein, unless otherwise indicated, refers to any native CCL18 (chemokine (C-C motif) ligand 18) from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). CCL18 is also known in the art as lung activation-regulated chemokine (PARC), dendritic Cell (DC) chemokine 1 (DC-CK 1), surrogate macrophage activation-related CC chemokine-1 (AMAC-1), and macrophage inflammatory protein-4 (MIP-4). The term encompasses "full-length" unprocessed CCL18, as well as any form of CCL18 that results from processing in a cell. The term also encompasses naturally occurring variants of CCL18, such as splice variants or allelic variants. The nucleic acid sequence of exemplary human CCL18 is set forth in SEQ ID NO:39 (NCBI reference sequence: NM-002988.4). The amino acid sequence of an exemplary protein encoded by human CCL18 is shown in SEQ ID NO 40 (UNIPROT) TM Accession number P55774-1).
The term "CCL19" as used herein, unless otherwise indicated, refers to any native CCL19 (chemokine (C-C motif) ligand 19) from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). CCL19 is also in the art Known as EBI1 ligand chemokine (ELC) and macrophage inflammatory protein-3-beta (MIP-3-beta). The term encompasses "full-length" unprocessed CCL19, as well as any form of CCL19 that results from processing in a cell. The term also encompasses naturally occurring variants of CCL19, such as splice variants or allelic variants. The nucleic acid sequence of exemplary human CCL19 is set forth in SEQ ID NO:41 (NCBI reference sequence: NM-006274.3). The amino acid sequence of an exemplary protein encoded by human CCL19 is shown in SEQ ID NO 42 (UNIPROT) TM Accession number Q99731-1).
The term "CCL21" as used herein, unless otherwise indicated, refers to any native CCL21 (chemokine (C-C motif) ligand 21) from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). CCL21 is also known in the art as 6Ckine, exodus-2 and secondary lymphoid tissue chemokine (SLC). The term encompasses "full-length" unprocessed CCL21, as well as any form of CCL21 that results from processing in a cell. The term also encompasses naturally occurring variants of CCL21, such as splice variants or allelic variants. The nucleic acid sequence of exemplary human CCL21 is set forth in SEQ ID NO 43 (NCBI reference: NM-002989.4). The amino acid sequence of an exemplary protein encoded by human CCL21 is shown in SEQ ID NO 44 (UNIPROT) TM Accession number O00585-1).
The term "CXCL9" as used herein, unless otherwise indicated, refers to any native CXCL9 (chemokine (C-X-C motif) ligand 9) from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). CXCL9 is also known in the art as gamma interferon-induced Monokine (MIG). The term encompasses "full-length" unprocessed CXCL9, as well as any form of CXCL9 that results from processing in a cell. The term also encompasses naturally occurring variants of CXCL9, such as splice variants or allelic variants. The nucleic acid sequence of exemplary human CXCL9 is set forth in SEQ ID NO:45 (NCBI reference: NM-002416.3). The amino acid sequence of an exemplary protein encoded by human CXCL9 is shown in SEQ ID NO 46 (UNIPROT) TM Logging inNumber Q07325-1).
The term "CXCL10" as used herein, unless otherwise indicated, refers to any native CXCL10 (C-X-C motif chemokine ligand 10) from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). CXCL10 is also known in the art as interferon gamma inducible protein 10 (IP-10) or small inducible cytokine B10. The term encompasses "full-length" unprocessed CXCL10, as well as any form of CXCL10 that results from processing in a cell. The term also encompasses naturally occurring variants of CXCL10, such as splice variants or allelic variants. The nucleic acid sequence of exemplary human CXCL10 is set forth in SEQ ID NO:47 (NCBI reference: NM-001565.4). The amino acid sequence of an exemplary protein encoded by human CXCL10 is shown in SEQ ID NO 48 (UNIPROT) TM Accession number P02778-1).
The term "CXCL11" as used herein, unless otherwise specified, refers to any native CXCL11 (C-X-C motif chemokine ligand 11) from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). CXCL11 is also known in the art as interferon-inducible T cell alpha chemoattractant (I-TAC) and interferon-gamma inducible protein 9 (IP-9). The term encompasses "full-length" unprocessed CXCL11, as well as any form of CXCL11 that results from processing in a cell. The term also encompasses naturally occurring variants of CXCL11, such as splice variants or allelic variants. The nucleic acid sequence of exemplary human CXCL11 is set forth in SEQ ID NO:49 (NCBI reference sequence: NM-005409.5). The amino acid sequence of an exemplary protein encoded by human CXCL11 is shown in SEQ ID NO:50 (UNIPROT) TM Accession number O14625-1).
The term "CXCL13" as used herein, unless otherwise specified, refers to any native CXCL13 (C-X-C motif chemokine ligand 13) from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). CXCL13 is also known in the art as B Lymphocyte Chemoattractant (BLC) and B cell attraction Chemokine 1 (BCA-1). The term encompasses "full-length" unprocessed CXCL13, as well as any form of CXCL13 that results from processing in a cell. The term also encompasses naturally occurring variants of CXCL13, such as splice variants or allelic variants. The nucleic acid sequence of exemplary human CXCL13 is set forth in SEQ ID NO:51 (NCBI reference sequence: NM-006419.2). The amino acid sequence of an exemplary protein encoded by human CXCL13 is shown in SEQ ID NO 52 (UNIPROT) TM Accession number O43927-1).
Unless otherwise indicated, the term "CD8A" as used herein refers to a cluster of differentiated 8A genes, including any native CD8A from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). The term encompasses "full-length" unprocessed CD8A, as well as any form of CD8A resulting from processing in a cell. The term also encompasses naturally occurring variants of CD8A, such as splice variants or allelic variants. Exemplary nucleic acid sequence of human CD8A is set forth in SEQ ID NO 53 (GENBANK) TM Accession number M12828.1). The amino acid sequence of an exemplary protein encoded by human CD8A is shown in SEQ ID NO 54 (UNIPROT) TM Accession number P01732-1).
Unless otherwise indicated, the term "EOMES" as used herein refers to an apoprotein gene, including any native EOMES from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). EOMES is also known in the art as T-box brain protein 2 (Tbr 2). The term encompasses "full-length" unprocessed EOMES, as well as any form of EOMES that results from processing in a cell. The term also encompasses naturally occurring variants of EOMES, such as splice variants or allelic variants. The nucleic acid sequence of an exemplary human EOMES is set forth in SEQ ID NO:55 (NCBI reference: NM-005442.4). The amino acid sequence of an exemplary protein encoded by human EOMES is shown in SEQ ID NO 56 (UNIPROT) TM Accession number O95936-1).
The term "GZMA" as used herein, unless otherwise indicated, refers to the granzyme a gene, including from any ridgeAny native GZMA of vertebrate origin, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). The term encompasses "full-length" unprocessed GZMA, as well as any form of GZMA that results from processing in a cell. The term also encompasses naturally occurring variants of GZMA, such as splice variants or allelic variants. Exemplary nucleic acid sequences of human GZMA are set forth in SEQ ID NO:57 (GENBANK) TM Accession number BC 015739). The amino acid sequence of an exemplary protein encoded by human GZMA is shown in SEQ ID NO:58 (UNIPROT) TM Accession number P12544-1).
Unless otherwise indicated, the term "TBX21" as used herein refers to the T-box transcription factor TBX21 gene, including any native TBX21 from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). TBX21 is also known in the art as T-PET, T-beta, TBLYM and T-box21. The term encompasses "full-length" unprocessed TBX21, as well as any form of TBX21 that results from processing in a cell. The term also encompasses naturally occurring variants of TBX21, such as splice variants or allelic variants. The nucleic acid sequence of an exemplary human TBX21 is set forth in SEQ ID NO:59 (NCBI reference sequence: NM-013351.2). The amino acid sequence of an exemplary protein encoded by human TBX21 is shown in SEQ ID NO:60 (UNIPROT) TM Accession number Q9UL 17-1).
Unless otherwise indicated, the term "IFNG" as used herein refers to the interferon gamma gene, including any native IFNG from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). IFNG is also known in the art as type II interferon. The term encompasses "full-length" unprocessed IFNG, as well as any form of IFNG that results from processing in a cell. The term also encompasses naturally occurring variants of IFNG, such as splice variants or allelic variants. The nucleic acid sequence of an exemplary human IFNG is set forth in SEQ ID NO:61 (NCBI reference sequence: NM-000619.3). The amino acid sequence of an exemplary protein encoded by human IFNG is shown in SEQ ID NO: 62(UNIPROT TM Accession number P01579-1).
The term "GZMB," as used herein, unless otherwise indicated, refers to the granzyme B gene, including any native GZMB from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). The term encompasses "full-length" unprocessed GZMB, as well as any form of GZMB that results from processing in a cell. The term also encompasses naturally occurring variants of GZMB, such as splice variants or allelic variants. Exemplary nucleic acid sequences of human GZMB are set forth in SEQ ID NO:63 (GENBANK) TM Accession number J03072). The amino acid sequence of an exemplary protein encoded by human GZMB is shown in SEQ ID NO 64 (UNIPROT) TM Accession number P10144-1).
The term "DERL3" as used herein, unless otherwise indicated, refers to the derlin-3 gene, including any native DERL3 from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). The term encompasses "full-length" unprocessed DERL3, as well as any form of DERL3 that results from processing in a cell. The term also encompasses naturally occurring variants of DERL3, such as splice variants or allelic variants. The nucleic acid sequence of an exemplary human DERL3 is set forth in SEQ ID NO:65 (European nucleotide archive accession No. AK 125830.1). The amino acid sequence of an exemplary protein encoded by human DERL3 is shown in SEQ ID NO 66 (UNIPROT) TM Accession number Q96Q 80-1).
The term "JSRP1" as used herein, unless otherwise specified, refers to the connecting sarcoplasmic reticulin 1 gene, including any native JSRP1 from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). The term encompasses "full-length" unprocessed JSRP1, as well as any form of JSRP1 that results from processing in a cell. The term also encompasses naturally occurring variants of JSRP1, such as splice variants or allelic variants. An exemplary nucleic acid sequence of human JSRP1 is set forth in SEQ ID NO 67 (European nucleotides)Archive accession number BC 021201.2). The amino acid sequence of an exemplary protein encoded by human JSRP1 is shown in SEQ ID NO 68 (UNIPROT) TM Accession number Q96MG 2-1).
Unless otherwise indicated, the term "IGHG2" as used herein refers to an immunoglobulin heavy chain constant γ 2 gene, including any native IGHG2 from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). The term encompasses "full-length" unprocessed IGHG2, as well as any form of IGHG2 that results from processing in a cell. The term also encompasses naturally occurring variants of IGHG2, such as splice variants or allelic variants. The nucleic acid sequence of exemplary human IGHG2 is set forth in SEQ ID NO:69 (European nucleotide archive accession number AL 928742.3). The amino acid sequence of an exemplary protein encoded by human IGHG2 is shown in SEQ ID NO 70 (UNIPROT) TM Accession number P01859-1).
The term "IGHGP" as used herein, unless otherwise indicated, refers to an immunoglobulin heavy chain constant gamma P gene, including any native IGHGP from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). The term encompasses "full-length" unprocessed IGHGP, as well as any form of IGHGP that results from processing in a cell. The term also encompasses naturally occurring variants of IGHGP, such as splice variants or allelic variants. The nucleic acid sequence of an exemplary human IGHGP is set forth in SEQ ID NO:71 (NCBI reference sequence No. NG _ 001019.6).
The term "IGLV3-1" as used herein, unless otherwise indicated, refers to an immunoglobulin λ variable 3-1 gene, including any native IGLV3-1 from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). The term encompasses "full-length" unprocessed IGLV3-1, as well as any form of IGLV3-1 that results from processing in the cell. The term also encompasses naturally occurring variants of IGLV3-1, such as splice variants or allelic variants. Exemplary human IGLV3-1 nucleus The sequence is set forth in SEQ ID NO:72 (European nucleotide archive accession No. AC 2458028.2). The amino acid sequence of an exemplary protein encoded by human IGLV3-1 is shown in SEQ ID NO 73 (UNIPROT) TM Accession number P01715-1).
The term "IGLV6-57" as used herein, unless otherwise indicated, refers to an immunoglobulin λ variable 6-57 gene, including any native IGLV6-57 from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). The term encompasses "full-length" unprocessed IGLV6-57, as well as any form of IGLV6-57 that results from processing in the cell. The term also encompasses naturally occurring variants of IGLV6-57, such as splice variants or allelic variants. The nucleic acid sequence of exemplary human IGLV6-57 is set forth in SEQ ID NO:74 (European nucleotide archive accession number AC 245760.1). The amino acid sequence of an exemplary protein encoded by human IGLV6-57 is shown in SEQ ID NO 75 (UNIPROT) TM Accession number P01721-1).
Unless otherwise indicated, the term "IGHA2" as used herein refers to an immunoglobulin heavy chain constant α 2 gene, including any native IGHG2 from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). The term encompasses "full-length" unprocessed IGHA2, as well as any form of IGHA2 that results from processing in a cell. The term also encompasses naturally occurring variants of IGHA2, such as splice variants or allelic variants. The nucleic acid sequence of an exemplary human IGHA2 is set forth in SEQ ID NO:76 (European nucleotide archive accession number AL 928742.3). The amino acid sequence of an exemplary protein encoded by human IGHA2 is shown in SEQ ID NO 77 (UNIPROT) TM Accession number P01877-1).
Unless otherwise indicated, the term "IGKV4-1" as used herein refers to immunoglobulin kappa variable 4-1 genes, including any native IGKV4-1 from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). The term encompasses the absence of "full lengthIndustrial IGKV4-1, and any form of IGKV4-1 that results from processing in cells. The term also encompasses naturally occurring variants of IGKV4-1, such as splice variants or allelic variants. The nucleic acid sequence of an exemplary human IGKV4-1 is set forth in SEQ ID NO:78 (European nucleotide archive accession number X02990.1). The amino acid sequence of an exemplary protein encoded by human IGKV4-1 is shown in SEQ ID NO:79 (UNIPROT) TM Accession number P06312-1).
The term "IGKV1-12" as used herein, unless otherwise indicated, refers to immunoglobulin kappa variable 1-12 genes, including any native IGKV1-12 from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). The term encompasses "full-length" unprocessed IGKV1-12, as well as any form of IGKV1-12 that results from processing in a cell. The term also encompasses naturally occurring variants of IGKV1-12, such as splice variants or allelic variants. The nucleic acid sequence of an exemplary human IGKV1-12 is set forth in SEQ ID NO:80 (European nucleotide archive accession number AC 24579.2). The amino acid sequence of an exemplary protein encoded by human IGKV1-12 is shown in SEQ ID NO 81 (UNIPROT) TM Accession number A0A0C4DH 73-1).
The term "IGLC7" as used herein, unless otherwise indicated, refers to the immunoglobulin λ constant 7 gene, including any native IGLC7 from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). The term encompasses "full-length" unprocessed IGLC7, as well as any form of IGLC7 that results from processing in a cell. The term also encompasses naturally occurring variants of IGLC7, such as splice variants or allelic variants. The nucleic acid sequence of exemplary human IGLC7 is set forth in SEQ ID NO:82 (European nucleotide archive accession number AC 245973.2). The amino acid sequence of an exemplary protein encoded by human IGLC7 is shown in SEQ ID NO 83 (UNIPROT) TM Accession number A0M8Q 6-1).
The term "clonally expanded B cells" refers to B cells that have a common antigen specificity as assessed by, for example, sequence homology to the migg portion of the BCR. For example, clonally expanded B cells may share at least 85% sequence identity (e.g., 85%, 86%, 87%, 88%, 89%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99%, 99.9%, or 100% sequence identity) in their mIg portion heavy and/or light chains, e.g., 85%, 86%, 87%, 88%, 89%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99%, 99.9%, or 100% sequence identity in the CDR1, CDR2, and/or CDR3 regions of their migg portion heavy and/or light chains.
The terms "cancer" and "cancerous" refer to or describe the physiological condition in mammals that is typically characterized by uncontrolled cell growth. Examples of cancer include, but are not limited to, carcinoma, lymphoma, blastoma, sarcoma, and leukemia or lymphoid malignancies. More specific examples of such cancers include, but are not limited to: lung cancer, including small cell lung cancer, NSCLC (e.g., non-squamous NSCLC and squamous NSCLC), adenocarcinoma of the lung, and squamous carcinoma of the lung; bladder cancer (e.g., urothelial Cancer (UC), muscle Invasive Bladder Cancer (MIBC), and BCG refractory non-muscle invasive bladder cancer (NMIBC)); kidney or renal cancer (e.g., renal Cell Carcinoma (RCC)); urinary tract cancer; breast cancer (e.g., HER2+ breast cancer and Triple Negative Breast Cancer (TNBC), which refers to estrogen receptor (ER-), progestin receptor (PR-) and HER2 (HER 2-) being negative); prostate cancer, such as castration-resistant prostate cancer (CRPC); peritoneal cancer; hepatocellular carcinoma; gastric cancer (gastric/gastric cancer), including gastrointestinal and gastrointestinal stromal cancer; pancreatic cancer; glioblastoma; cervical cancer; ovarian cancer; liver cancer; hepatoma; colon cancer; rectal cancer; carcinoma of large intestine; endometrial or uterine cancer; salivary gland cancer; prostate cancer; vulvar cancer; thyroid cancer; liver cancer; anal cancer; penile cancer; melanomas, including superficial invasive melanoma, malignant lentigo melanoma, peripheral macular malignant melanoma, and nodular melanoma; multiple myeloma and B-cell lymphomas (including low grade/follicular non-Hodgkin's lymphoma (NHL); small Lymphocytic (SL) NHL; moderate/follicular NHL; moderate diffuse NHL; hyperimmunoblastic NHL; high lymphocytic NHL; high small non-lytic NHL; giant lump NHL; mantle cell lymphoma; AIDS-related lymphoma; and Waldenstrom's Macroglobulinemia)); chronic Lymphocytic Leukemia (CLL); acute Lymphocytic Leukemia (ALL); acute Myeloid Leukemia (AML); hairy cell leukemia; chronic Myeloid Leukemia (CML); post-transplant lymphoproliferative disorder (PTLD); and myelodysplastic syndrome (MDS), as well as abnormal vascular proliferation associated with lentigo hamartoma, edema (such as diseases associated with brain tumors), meigs' syndrome, brain cancer, head and neck cancer, and related metastases.
The terms "cell proliferative disease" and "proliferative disease" refer to a condition associated with a degree of abnormal cell proliferation. In one embodiment, the cell proliferative disorder is cancer (e.g., lung cancer (e.g., NSCLC, including non-squamous NSCLC and squamous NSCLC), bladder cancer (e.g., UC), renal cancer (e.g., RCC), or breast cancer (e.g., TNBC)). In another embodiment, the cell proliferative disorder is a tumor.
A "chemotherapeutic agent" is a compound useful for treating cancer (e.g., lung cancer (e.g., NSCLC, including non-squamous NSCLC and squamous NSCLC), bladder cancer (e.g., UC), renal cancer (e.g., RCC), or breast cancer (e.g., TNBC)). Examples of chemotherapeutic agents include alkylating agents such as thiotepa and cyclophosphamide
Figure BDA0003990674580000501
Alkyl sulfonates such as busulfan, improsulfan, and piposulfan; aziridines such as benzotepa, carbaquinone, metodepa and uredepa; vinyl imines and methyl melamines, including tritylamine, triethylphosphoramide, triethylenethiophosphoramide, and trimethylolmelamine; polyacetylenyl (acetogenin, especially bucindocin and bucindolone); delta-9-tetrahydrocannabinol (dronabinol,
Figure BDA0003990674580000502
) (ii) a Beta-lapachone; lapachol; colchicine; betulinic acid; camptothecin (including the synthetic analogue topotecan)
Figure BDA0003990674580000511
CPT-11 (irinotecan,
Figure BDA0003990674580000512
) Acetyl camptothecin, scopoletin and 9-aminocamptothecin); bryostatins; cariostatin (callystatin); CC-1065 (including its aldorexin, kazelaixin, and bizelaixin synthetic analogs); podophyllotoxin; podophyllinic acid; teniposide; nostoc (especially nostoc 1 and nostoc 8); dolastatin; duocarmycins (including synthetic analogs, KW-2189 and CB1-TM 1); eleutherobin; (ii) coprinus atramentarius alkali; alcohol of coral tree; sponge chalone; nitrogen mustards such as chlorambucil, chlornaphazine, chlorophosphoramide, estramustine, ifosfamide, mechlorethamine oxide hydrochloride, melphalan, neonebixin, benzene mustard cholesterol, prednimustine, trofosfamide, uramustine; nitrosoureas such as carmustine, chlorourethrin, fotemustine, lomustine, nimustine and ranimustine; antibiotics, such as enediyne antibiotics (e.g., calicheamicin, particularly calicheamicin γ 1 'and calicheamicin ω 1' (see, e.g., nicolaou et al, angew. Chem Intl. Ed. Engl.,33, 183-186 (1994)); CDP323, oral α -4 integrin inhibitors, dalcomycin, including dalcomycin A, esperamicin, and neocarcinomycin chromophores and related tryptophane diyne antibiotic chromophores), acrinomycin, actinomycin, antromycin, azalomycin, azaserine, bleomycin, actinomycin C, karabixin, carminomycin, carvachin, tryptophacin, tryptophycin, actinomycin D, daunorubicin, ditorexin, 6-diazo-5-oxo-norleucine, doxorubicin, including doxorubicin
Figure BDA0003990674580000513
Morpholino-doxorubicin, cyano-morpholino-doxorubicin, 2-pyrroline-doxorubicin, doxorubicin hydrochloride liposome injection
Figure BDA0003990674580000514
LipidDoxorubicin TLC D-99
Figure BDA0003990674580000515
Pegylated liposomal doxorubicin
Figure BDA0003990674580000516
And doxorubicine), epirubicin, esorubicin, idarubicin, sisomicin, mitomycins such as mitomycin C, mycophenolic acid, nogomycin, olivomycin, pellomycin, pofimycin, puromycin, triiron doxorubicin, nodubicin, streptonigrin, streptozotocin, tubercidin, ubenimex, setastatin, zorubicin; antimetabolites, such as methotrexate, gemcitabine
Figure BDA0003990674580000517
Tegafur
Figure BDA0003990674580000518
Capecitabine
Figure BDA0003990674580000519
Epothilone and 5-fluorouracil (5-FU); folic acid analogs such as denopterin, methotrexate, pteropterin, trimetrexate; purine analogs such as fludarabine, 6-mercaptopurine, thiamine, thioguanine; pyrimidine analogs such as ancitabine, azacitidine, 6-azauridine, carmofur, arabinoside, dideoxyuridine, doxifluridine, enocitabine, and floxuridine; androgens such as carpoterone, drotandrosterone propionate, epitioandrostanol, meindrotane, testolactone; anti-adrenalines, such as aminoglutethimide, mitotane, trostane; folic acid replenisher such as folinic acid; d, D-glucuronolactone acetate; an aldphosphoramide glycoside; (ii) aminolevulinic acid; eniluracil; amsacrine; amoxicillin; a bisantrene group; edatrexae; 1, ground Budd famine; colchicine; diazaquinone; (ii) nilotinib; (ii) hydroxypyrazole acetate; an epothilone; etoglut; gallium nitrate; a hydroxyurea; lentinan; lonidamine; maytansinoids such as maytansine and ansamitocins; mitoxantrone Hydrazone; mitoxantrone; mopidamole; diamine nitracridine; pentostatin; methionine; pirarubicin; losoxanthraquinone; 2-ethyl hydrazide; methylbenzyl hydrazine;
Figure BDA0003990674580000521
polysaccharide complexes (JHS Natural Products, eugene, OR); lezoxan; rhizomycin; a texaphyrin; a germanium spiroamine; alternarionic acid; a tri-imine quinone; 2,2' -trichlorotriethylamine; trichothecene toxins (particularly T-2 toxin, verrucosin A, bacillocin A and serpentine); uratan; vindesine
Figure BDA0003990674580000522
Dacarbazine; mannitol mustard; dibromomannitol; dibromodulcitol; pipobroman; geseiguxin; cytarabine ("Ara-C"); thiotepa triamine; the taxane class(s) is (are), such as paclitaxel (A)
Figure BDA0003990674580000523
Albumin engineered nanoparticle formulation of Bristol-Myers Squibb Oncology, princeton, N.J.), paclitaxel (ABRAXANE) TM ) And docetaxel (c), (d)
Figure BDA0003990674580000524
Rhome-Poulene Rorer, antony, france), chlorambucil; 6-thioguanine; mercaptopurine; methotrexate; platinum analogs, such as cisplatin, platinum oxalate (e.g.,
Figure BDA0003990674580000525
) And carboplatin; catharanthus roseus for preventing tubulin polymerization to form microtubules, including vinblastine
Figure BDA0003990674580000526
Vincristine
Figure BDA0003990674580000527
Vindesine
Figure BDA0003990674580000528
And vinorelbine
Figure BDA0003990674580000529
Etoposide (VP-16); an ifosfamide; mitoxantrone; aldehyde hydrofolic acid; noscapine; edatrexae; daunomycin; aminopterin; iban phosphate; topoisomerase inhibitor RFS 2000; difluoromethyl ornithine (DMFO); retinoids such as retinoic acid, including bexarotene
Figure BDA00039906745800005210
Diphosphoric hydrochloric acids, such as chlorophosphate (e.g.,
Figure BDA00039906745800005211
or
Figure BDA00039906745800005212
) Etidrophosphates of formula (I)
Figure BDA00039906745800005213
NE-58095, zoledronic acid/zoledronic acid salt
Figure BDA00039906745800005214
Alendronate
Figure BDA00039906745800005215
Pamidronate salt
Figure BDA00039906745800005216
Tiluphosphate salt
Figure BDA00039906745800005217
Or risedronate
Figure BDA00039906745800005218
And troxacitabine (1, 3-dioxolane nucleoside cytosine analogues); antisense oligonucleotides, particularly those that inhibit the expression of genes in signaling pathways involved in abnormal cell proliferation, can decrease cell proliferation, e.g., PKC-alpha, raf, H-Ras and epidermal growth factor receptor (EGF-R) (examples)Such as erlotinib (TARCEVA) TM ) ); and VEGF-A; vaccines, e.g.
Figure BDA00039906745800005219
Vaccines and gene therapy vaccines, e.g.
Figure BDA00039906745800005220
A vaccine,
Figure BDA00039906745800005221
Vaccines and
Figure BDA00039906745800005222
a vaccine; a topoisomerase 1 inhibitor (for example,
Figure BDA0003990674580000531
) (ii) a The rmRH (for example,
Figure BDA0003990674580000532
) (ii) a BAY439006 (Sorafenib; bayer); SU-11248 (sunitinib,
Figure BDA0003990674580000533
pfizer); pirifoxin, COX-2 inhibitors (e.g., celecoxib or etoxib), proteasome inhibitors (e.g., PS 341); bortezomib
Figure BDA0003990674580000534
CCI-779; tipifarnib (R11577); sorafenib, ABT510; bcl-2 inhibitors such as sodium orbellison
Figure BDA0003990674580000535
Pixantrone; an EGFR inhibitor; tyrosine kinase inhibitors; serine-threonine kinase inhibitors such as rapamycin (sirolimus,
Figure BDA0003990674580000536
) (ii) a Farnesyl transferase inhibitors such as Lonafarnib (SCH 6636, sarasar) TM ) (ii) a And any pharmaceutically acceptable salt, acid or derivative thereof as described above;and combinations of two or more of the above, such as CHOP (abbreviation for cyclophosphamide, doxorubicin, vincristine and prednisolone combination therapy) and FOLFOX (oxaliplatin) TM ) Abbreviations for therapeutic regimens combining 5-FU and folinic acid), as well as any pharmaceutically acceptable salts, acids or derivatives thereof, described above; and combinations of two or more of the foregoing.
Chemotherapeutic agents as defined herein also include "anti-hormonal agents" or "endocrine therapeutic agents" for modulating, reducing, blocking or inhibiting the effects of hormones that can promote the growth of cancer (e.g., lung cancer (e.g., NSCLC, including non-squamous NSCLC and squamous NSCLC), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), or breast cancer (e.g., TNBC)). They may themselves be hormones, including but not limited to: antiestrogens and Selective Estrogen Receptor Modulators (SERMs), including, for example, tamoxifen (including
Figure BDA0003990674580000537
Tamoxifen), raloxifene, droloxifene, 4-hydroxyttamoxifen, troxifene, keoxifene, LY117018, onapristone and
Figure BDA0003990674580000538
(toremifene); aromatase inhibitors which inhibit aromatase, which regulates the production of estrogen in the adrenal glands, such as 4 (5) -imidazoles, aminoglutarimides,
Figure BDA0003990674580000539
Megestrol acetate,
Figure BDA00039906745800005310
Exemestane, formestane (formastanie), fadrozole,
Figure BDA00039906745800005311
Vorozole (vorozole),
Figure BDA00039906745800005312
Letrozole and
Figure BDA00039906745800005313
anastrozole; and antiandrogens such as flutamide, nilutamide, bicalutamide, leuprorelin and goserelin; and troxacitabine (1, 3-dioxolane nucleoside analog); antisense oligonucleotides, particularly those that inhibit gene expression in signaling pathways implicated by abnormal cell proliferation, such as PKC- α, raf and H-Ras; ribozymes, such as VEGF expression inhibitors (e.g.,
Figure BDA00039906745800005314
ribozymes) and inhibitors of HER2 expression; vaccines, such as gene therapy vaccines, e.g.
Figure BDA00039906745800005315
A vaccine,
Figure BDA00039906745800005316
Vaccines and
Figure BDA00039906745800005317
a vaccine;
Figure BDA00039906745800005318
rIL-2;
Figure BDA00039906745800005319
a topoisomerase 1 inhibitor;
Figure BDA0003990674580000541
rmRH; vinorelbine (vinorelbine) and esperamicins (esperamicins) (see U.S. Pat. No. 4,675,187); and pharmaceutically acceptable salts, acids or derivatives of any of the foregoing; and combinations of two or more of the foregoing.
The term "chimeric" antibody refers to an antibody in which a portion of the heavy and/or light chain is derived from a particular source or species, while the remainder of the heavy and/or light chain is derived from a different source or species.
"class" of antibody refers toThe type of constant domain or constant region that the heavy chain has. There are five major classes of antibodies: igA, igD, igE, igG and IgM, and some of these antibodies may be further divided into subclasses (isotypes), e.g., igG 1 、IgG 2 、IgG 3 、IgG 4 、IgA 1 And IgA 2 . The heavy chain constant domains corresponding to different classes of immunoglobulins are referred to as α, δ, ε, γ, and μ, respectively.
As used herein, the term "cytotoxic agent" refers to a substance that inhibits or prevents cellular function and/or causes cell death or destruction. Cytotoxic agents include, but are not limited to, radioisotopes (e.g., at) 211 、I 131 、I 125 、Y 90 、Re 186 、Re 188 、Sm 153 、Bi 212 、P 32 、Pb 212 And radioactive isotopes of Lu); chemotherapeutic agents or drugs (e.g., methotrexate, doxorubicin, vinca alkaloids (vincristine, vinblastine, etoposide), doxorubicin, melphalan, mitomycin C, chlorambucil, daunorubicin, or other intercalating agents); a growth inhibitor; enzymes and fragments thereof such as nucleolytic enzymes; an antibiotic; toxins such as small molecule toxins or enzymatically active toxins of bacterial, fungal, plant or animal origin, including fragments and/or variants thereof; and various anti-tumor or anti-cancer agents disclosed below.
The term "concurrently" as used herein refers to administration of two or more therapeutic agents, wherein at least some of the administrations overlap in time. Thus, concurrent administration includes a dosing regimen that continues administration of one or more additional agents after discontinuing administration of one or more agents.
As used herein, "delaying" the progression of a condition or disease means delaying, impeding, slowing, stabilizing, and/or delaying the progression of the disease or condition (e.g., cancer, such as lung cancer (e.g., NSCLC, including non-squamous NSCLC and squamous NSCLC), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), or breast cancer (e.g., TNBC)). Such delays may be of varying lengths of time, depending on the medical history and/or the subject to be treated. It will be apparent to those skilled in the art that a sufficient or significant delay may actually encompass prevention, as the subject will not suffer from the disease.
The terms "determining", "detecting" and grammatical variations thereof include any means of determining or detecting, including direct and indirect determination or detection.
By "disorder" or "disease" is meant any condition that may benefit from treatment, including, but not limited to, chronic and acute disorders or diseases, including those pathological conditions that predispose a mammal to the disorder (e.g., cancer, such as lung cancer (e.g., NSCLC, including non-squamous NSCLC and squamous NSCLC), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), or breast cancer (e.g., TNBC)).
The term "diagnosis" as used herein refers to the determination or classification of a molecular or pathological condition, disease or disorder, such as cancer, e.g., lung cancer (e.g., NSCLC, including non-squamous NSCLC and squamous NSCLC), bladder cancer (e.g., UC), renal cancer (e.g., RCC), or breast cancer (e.g., TNBC). For example, "diagnosis" may refer to the identification of a particular type of cancer. "diagnosis" may also refer to the classification of a particular subtype of cancer, for example, by histopathological criteria or molecular features (e.g., a subtype characterized by expression of one or a combination of biomarkers (e.g., a particular gene or protein encoded by such gene)).
"Effector function" refers to those biological activities that can be attributed to the Fc region of an antibody that vary with the isotype of the antibody. Examples of antibody effector functions include: c1q binding and Complement Dependent Cytotoxicity (CDC); fc receptor binding; antibody-dependent cell-mediated cytotoxicity (ADCC); phagocytosis; down-regulation of cell surface receptors (e.g., PD-L1); and B cell activation.
An "effective amount" of a compound, e.g., a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., an atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) or a composition thereof (e.g., a pharmaceutical composition), is the minimum amount to achieve a desired therapeutic or prophylactic effect, such as a measurable increase in Overall Survival (OS), progression-free survival (PFS), or overall response (e.g., a determined optimal overall response (BCOR)) of a particular disease or condition (e.g., cancer, e.g., lung cancer (e.g., NSCLC, including non-squamous NSCLC and squamous NSCLC), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), or breast cancer (e.g., TNBC)). An effective amount herein may vary depending on factors such as the disease state, age, sex, and weight of the individual, and the ability of the antibody to elicit a desired response in the subject. An effective amount is also one in which any toxic or detrimental effects of the treatment are outweighed by the therapeutically beneficial effects. For prophylactic use, beneficial or desired results include, for example, elimination or reduction of risk, lessening of severity, or delaying onset of the disease, which includes biochemical, histological, and/or behavioral symptoms of the disease, complications thereof, and intermediate pathological phenotypes that arise during the course of disease development. The effective amount may be administered one or more times. For the purposes of this disclosure, an effective amount of a drug, compound or pharmaceutical composition is an amount sufficient for direct or indirect prophylaxis or treatment. As understood in the clinical setting, an effective amount of a drug, compound or pharmaceutical composition can optionally be achieved in combination with another drug, compound or pharmaceutical composition. Thus, an "effective amount" may be considered in the context of administering one or more therapeutic agents, and administration of an effective amount of a single agent may be considered if the desired result can be achieved or achieved in combination with one or more other agents. For example, an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) as a cancer treatment can reduce the number of cancer cells; reducing primary tumor size; inhibit (i.e., slow to some extent and preferably stop) cancer cell infiltration into peripheral organs; inhibit (i.e., slow and preferably stop to some extent) tumor metastasis; inhibit tumor growth to some extent; and/or relieve to some extent one or more symptoms associated with the condition. To the extent that the drug prevents growth and/or kills existing cancer cells, it can inhibit cell growth and/or be cytotoxic. For cancer therapy, in vivo efficacy can be measured, for example, by assessing survival time, time to disease progression (TTP), response Rate (RR), duration of response, and/or quality of life.
The term "Fc region" is used herein to define the C-terminal region of an immunoglobulin heavy chain, which comprises at least a portion of a constant region. The term includes native sequence Fc regions and variant Fc regions. In one embodiment, the human IgG heavy chain Fc region extends from Cys226 or from Pro230 to the carboxy terminus of the heavy chain. However, the C-terminal lysine (Lys 447) of the Fc region may or may not be present. Unless otherwise specified herein, the numbering of amino acid residues in the Fc region or constant region is according to the EU numbering system, also known as the EU index, as described in Kabat et al, sequences of Proteins of Immunological Interest, 5 th edition, public Health Service, national Institutes of Health, bethesda, MD, 1991.
"framework" or "FR" refers to variable domain residues other than hypervariable region (HVR) residues. The FRs of a variable domain typically consist of the following four FR domains: FR1, FR2, FR3 and FR4. Thus, HVR and FR sequences typically occur in the VH (or VL) as follows: FR1-H1 (L1) -FR2-H2 (L2) -FR3-H3 (L3) -FR4.
The terms "full-length antibody," "intact antibody," and "whole antibody" are used interchangeably herein to refer to an antibody having a structure substantially similar to a native antibody structure or having a heavy chain containing an Fc region as defined herein.
A "human antibody" is an antibody having an amino acid sequence corresponding to that of an antibody produced by a human or human cell, or derived from an antibody of non-human origin using a repertoire of human antibodies or other human antibody coding sequences. This definition of human antibody specifically excludes humanized antibodies comprising non-human antigen binding residues. Human antibodies, including phage display libraries, can be generated using a variety of techniques known in the art. Hoogenboom and Winter, j.mol.biol.,227 (1991); marks et al, j.mol.biol.,222 (1991). Also useful for the preparation of human Monoclonal Antibodies are methods such as Cole et al, monoclonal Antibodies and Cancer Therapy, alan R.Liss, p.77 (1985); boerner et al, J.Immunol.,147 (1): 86-95 (1991). See also van Dijk et al, curr, opin, pharmacol, 5. Human antibodies can be made by administering an antigen to a transgenic animal that has been modified to produce such antibodies in response to an antigen challenge but has failed at its endogenous locus, e.g., to immunize a XENOMOUSE (see, e.g., U.S. Pat. Nos. 6,075,181 and 6,150,584 for Xenomose TM A technique). See also, e.g., li et al, proc.natl.acad.sci.usa,103, 3557-3562 (2006) for human antibodies produced by human B cell hybridoma technology.
A "humanized" antibody is a chimeric antibody comprising amino acid residues from non-human HVRs and amino acid residues from human FRs. In certain embodiments, a humanized antibody will comprise substantially all of at least one, and typically two, variable domains, in which all or substantially all of the HVRs (e.g., CDRs) correspond to those of a non-human antibody, and all or substantially all of the FRs correspond to those of a human antibody. The humanized antibody optionally may comprise at least a portion of an antibody constant region derived from a human antibody. An antibody that is a "humanized form," e.g., a non-human antibody, refers to an antibody that has been humanized.
The term "hypervariable region" or "HVR" as used herein refers to each of the regions in the sequence that are hypervariable ("complementarity determining regions" or "CDRs") and/or form structurally defined loops ("hypervariable loops") and/or antibody variable domains containing antigen-contacting residues ("antigen-contacting points"). Typically, an antibody comprises six HVRs: three in VH (H1, H2, H3) and three in VL (L1, L2, L3). Exemplary HVRs herein include:
(a) Highly variable loops occurring at the following amino acid residues: 26 to 32 (L1), 50 to 52 (L2), 91 to 96 (L3), 26 to 32 (H1), 53 to 55 (H2) and 96 to 101 (H3) (Chothia and Lesk, J.mol.biol.196:901-917 (1987));
(b) CDRs occurring at amino acid residues 24-34 (L1), 50-56 (L2), 89-97 (L3), 31-35b (H1), 50-65 (H2) and 95-102 (H3) (Kabat et al, sequences of Proteins of Immunological Interest, 5 th edition, public Health Service, national Institutes of Health, bethesda, MD (1991));
(c) Antigen contacts occurring at amino acid residues 27c-36 (L1), 46-55 (L2), 89-96 (L3), 30-35b (H1), 47-58 (H2), and 93-101 (H3) (MacCallum et al, J.mol.biol.262:732-745 (1996)); and
(d) A combination of (a), (b), and/or (c) that comprises HVR amino acid residues 46-56 (L2), 47-56 (L2), 48-56 (L2), 49-56 (L2), 26-35 (H1), 26-35b (H1), 49-65 (H2), 93-102 (H3), and 94-102 (H3).
Unless otherwise indicated, HVR residues and other residues (e.g., FR residues) in the variable domains are numbered herein according to Kabat et al, supra.
An "isolated" antibody is one that has been separated from components of its natural environment. In some embodiments, the antibody is purified to greater than 95% or 99% purity as determined, for example, by electrophoresis (e.g., SDS-PAGE, isoelectric focusing (IEF), capillary electrophoresis), or chromatography (e.g., ion exchange or reverse phase HPLC). For a review of methods for assessing antibody purity, see, e.g., flatman et al, j.chromager.b 848 (2007).
An "isolated" nucleic acid is a nucleic acid molecule that has been separated from components of its natural environment. An isolated nucleic acid includes a nucleic acid molecule that is contained in a cell that normally contains the nucleic acid molecule, but which is present extrachromosomally or at a chromosomal location that is different from its natural chromosomal location.
As used herein, the word "label" refers to a detectable compound or composition. Labels are typically conjugated or fused, directly or indirectly, to an agent, such as a polynucleotide probe or antibody, and facilitate detection of the conjugated or fused agent. The label may be detectable by itself (e.g., radioisotope labels or fluorescent labels) or, in the case of an enzymatic label, may catalyze chemical alteration of a substrate compound or composition to produce a detectable product.
In general, the terms "level of expression" or "expression level" are used interchangeably and generally refer to the amount of a biomarker in a biological sample. "expression" generally refers to the process by which information (e.g., gene-encoded and/or epigenetic) is converted into structures present in and operating in a cell. Thus, as used herein, "expression" may refer to transcription into a polynucleotide, translation into a polypeptide, or even polynucleotide and/or polypeptide modifications (e.g., post-translational modifications of a polypeptide). Transcribed polynucleotides, translated polypeptides, or fragments of polynucleotide and/or polypeptide modifications (e.g., post-translational modifications of polypeptides) should also be considered as expressed, whether they are derived from transcripts generated by alternatively spliced or degraded transcripts, or from post-translational processing (e.g., by proteolysis) of polypeptides. "expressed genes" include those that are transcribed into a polynucleotide, such as an mRNA, and then translated into a polypeptide, and also those that are transcribed into RNA but not translated into a polypeptide (e.g., transfer RNA and ribosomal RNA). Expression levels can be measured by methods known to those skilled in the art and also disclosed herein, including, for example, RT-qPCR and RNA-seq. The assessed expression level can be used to determine a response to the treatment.
The term "immune score expression level" as used herein refers to a numerical value that reflects the expression level of a single gene of interest (e.g., normalized expression level) or the collective expression level of multiple genes of interest (e.g., at least two, at least three, at least four, at least five, or more genes of interest) that are associated with an immune response. The immune score expression level of more than one gene of interest can be determined by collective methods known to those skilled in the art and also disclosed herein, including, for example, by calculating the median or mean of the expression levels of all genes of interest. Prior to pooling, the expression level of each gene of interest can be normalized using statistical methods known to those skilled in the art and disclosed herein, including, for example, normalization to the expression level of one or more housekeeping genes, or to the total library size, or to the median or average expression level value of all measured genes. In some cases, the normalized expression level of each gene of interest may be normalized by calculating a Z-score for the normalized expression level of each gene of interest prior to the plurality of sets of genes of interest. In some cases, each gene of interest may have a weight score assigned, and the immune score expression level of a plurality of genes of interest may be calculated by combining the weight scores to determine a mean of the weighted expression levels of all genes of interest. For example, an immune score expression level can refer to a value reflecting the normalized expression level of a single gene selected from any one of tables 1 to 17 (e.g., CD79A, CD19, BANK1, jchanin, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, MZB1, CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, CXCL13, DERL3, JSRP1, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, and IGLC 7). Alternatively, the immune score expression level may, for example, refer to an expression level that reflects a mean (e.g., normalized) expression level of at least two, at least three, at least four, at least five, at least six, at least seven, at least eight, at least nine, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, or a normalized expression level (e.g., normalized expression level of at least 18, such as a normalized expression level or a normalized expression level of at least 18, such as a normalized expression level of a set of expression levels (e.g., a normalized expression level of at least 18, at least 19, or a normalized expression level of at least two, such as CD79A, CD19, BANK1, jchan 1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, rbj, mzj, MZB1, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, IGKV1, IGLC 11, IGLC 13, IGLC7, or a combination thereof). In some cases, an immune score expression level can, for example, refer to a level that reflects the expression of a gene listed in any one of tables 1 to 17 (e.g., CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, MZB1, CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, CXCL13, DERL3, JSRP1, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, and IGLC7, or combinations thereof) at least two, at least three, at least four, at least five, at least six, at least seven, at least eight, at least nine, at least 10, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19, or more of the collective Z-score (e.g., the normalized Z-score or the normalized Z-score of the expression levels.
As used herein, the term "reference immune score expression level" refers to an immune score expression level to which another immune score expression level (e.g., for one or more of the genes listed in any one of tables 1 to 17 (e.g., CD79A, CD19, BANK1, jchanin, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, MZB1, CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, CXCL13, DERL3, JSRP1, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, and IGLC 7)) is compared to make, for example, a diagnostic, predictive, prognostic, and/or therapeutic decision. For example, a reference immune score expression level can be derived from a reference sample, an expression level in a reference population (e.g., for a gene listed in any one of tables 1-17 (e.g., one or more of CD79A, CD19, BANK1, jchanin, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, MZB1, CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, CXCL13, DERL3, JSRP1, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, and IGLC 7)) and/or a pre-specified value (e.g., a cut-off value that previously determined satisfies the following conditions: the cutoff value is based on a significant difference above and/or below the cutoff value between the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist therapy and the responsiveness of the individual to treatment with the non-PD-L1 axis binding antagonist therapy, the significant (e.g., statistical) difference distinguishing a first subset of individuals in a reference population that have received treatment with a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attrituximab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) from a second subset of individuals in the same reference population that have received treatment with a non-PD-L1 axis binding antagonist therapy that does not contain a PD-L1 axis binding antagonist, wherein the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist therapy is significantly (e.g., statistically) improved relative to the responsiveness of the individual to treatment with the non-PD-L1 axis binding antagonist therapy relative to the treatment with the cutoff value, and/or the responsiveness of the individual to treatment with the non-PD-L1 axis binding antagonist therapy is significantly (e.g., statistically) improved relative to the responsiveness to the non-PD-L1 axis binding antagonist therapy relative to the treatment An individual's responsiveness to treatment with a PD-L1 axis binding antagonist is significantly (e.g., statistically) improved below a threshold value). One skilled in the art will recognize that the numerical value of the reference immune score expression level may vary depending on the indication (e.g., cancer (e.g., breast cancer, lung cancer (e.g., NSCLC, including non-squamous NSCLC and squamous NSCLC), renal cancer, or bladder cancer), the method used to detect the expression level (e.g., RNA-seq or RT-qPCR), the statistical method used to generate the immune score, and/or the particular combination of genes examined.
By "increased expression", "increased expression level" or "increased level" is meant an increased level of expression of a gene or combination of genes (e.g., for one or more of the genes listed in any one of tables 1 to 17 (e.g., CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, MZB1, CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, CXCL13, DERL3, JSRP1, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, and IGLC 7)) in a subject relative to a control, such as an uninvolved disease or condition (e.g., a cancer, e.g., lung cancer (e.g., including non-NSCLC and NSCLC), bladder cancer (e.g., squamous cell carcinoma (e.g., renal carcinoma), e.g., a squamous cell carcinoma (e.g., a reference, e.g., a reference example, a squamous cell cancer) or a reference level, such as an immune or a reference example, a squamous cell, a breast cancer, a reference example, a.
By "reduced expression", "reduced expression level" or "reduced level" is meant a reduced level of expression of a gene or combination of genes (e.g., for one or more of the genes listed in any one of tables 1 to 17 (e.g., CD79A, CD19, BANK1, jchan, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, MZB1, CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, CXCL13, DERL3, JSRP1, IGHG2, IGHGP, igcl 3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, and IGLC 7)) in a subject relative to a control (such as an uninvolved disease or condition (e.g., a cancer, e.g., lung cancer (e.g., including non-NSCLC and NSCLC), bladder cancer (e.g., squamous cell carcinoma (e.g., TNBC), e.g., squamous cell carcinoma (e.g., a reference example, a reference level or a reference level of an immune or a reference example, such as a squamous cell cancer) or a reference example. In some embodiments, reduced expression is little or no expression.
As used herein, "reference gene" refers to a gene or set of genes (e.g., one, two, three, four, five, or six or more genes) for comparison purposes, such as a housekeeping gene. By "housekeeping gene" is meant herein a gene or set of genes (e.g., one, two, three, four, five, or six or more genes) that encodes a protein whose activity is critical for maintaining cell function and which is typically similarly present in all cell types.
The term "monoclonal antibody" as used herein refers to an antibody obtained from a substantially homogeneous population of antibodies, i.e., individual antibodies comprising the population share identity and/or bind the same epitope, except for possible variant antibodies (e.g., containing naturally occurring mutations or produced during the manufacture of a monoclonal antibody preparation, such variants typically being present in minor amounts). In contrast to polyclonal antibody preparations, which typically include different antibodies directed against different determinants (epitopes), each monoclonal antibody in a monoclonal antibody preparation is directed against a single determinant on the antigen. Thus, the modifier "monoclonal" indicates that the characteristics of the antibody are obtained from a substantially homogeneous population of antibodies, and is not to be construed as requiring production of the antibody by any particular method. For example, monoclonal antibodies for use in accordance with the present invention can be prepared by a variety of techniques, including but not limited to hybridoma methods, recombinant DNA methods, phage display methods, and methods that utilize transgenic animals containing all or part of a human immunoglobulin locus, such methods and other exemplary methods for preparing monoclonal antibodies are described herein.
"naked antibody" refers to an antibody that is not conjugated to a heterologous moiety (e.g., a cytotoxic moiety) or radiolabeled. The naked antibody may be present in a pharmaceutical formulation.
"Natural antibody" refers to a naturally occurring immunoglobulin molecule having a different structure. For example, a native IgG antibody is a heterotetrameric glycoprotein of about 150,000 daltons, consisting of two identical light chains and two identical heavy chains that are disulfide-bonded. From N-terminus to C-terminus, each heavy chain has a variable region (VH), also known as a variable heavy or heavy chain variable domain, followed by three constant domains (CH 1, CH2 and CH 3). Similarly, each light chain has, from N-terminus to C-terminus, a variable region (VL), also known as a variable light chain domain or light chain variable domain, followed by a constant light Chain (CL) domain. The light chain of an antibody can be assigned to one of two types, called kappa (κ) and lambda (λ), based on the amino acid sequence of its constant domain.
The term "oligonucleotide" refers to a relatively short polynucleotide (e.g., less than about 250 nucleotides in length), including, but not limited to, single-stranded deoxyribonucleotides, single-or double-stranded ribonucleotides, RNA: DNA hybrids, and double-stranded DNA. Oligonucleotides, such as single-stranded DNA probe oligonucleotides, are typically synthesized by chemical methods, for example using commercially available automated oligonucleotide synthesizers. However, oligonucleotides can be prepared by a variety of other methods, including in vitro recombinant DNA-mediated techniques and by expression of DNA in cells and organisms.
The term "package insert" is used to refer to instructions typically included in commercial packaging for therapeutic products that contain information regarding the indications, usage, dosage, administration, combination therapy, contraindications, and/or warnings concerning the use of such therapeutic products.
The term "pharmaceutical formulation" refers to a formulation that is in a form that allows for the biological activity of the active ingredient contained therein to be effective, and that is free of additional components having unacceptable toxicity to the subject to which the formulation is to be administered.
By "pharmaceutically acceptable carrier" is meant a component of a pharmaceutical formulation that is not toxic to the subject except for the active ingredient. Pharmaceutically acceptable carriers include, but are not limited to, buffers, excipients, stabilizers, or preservatives.
The term "protein" as used herein, unless otherwise indicated, refers to any native protein from any vertebrate source, including mammals such as primates (e.g., humans) and rodents (e.g., mice and rats). The term includes "full-length" unprocessed protein, as well as any form of protein produced by processing in a cell. The term also encompasses naturally occurring protein variants, such as splice variants or allelic variants.
"percent (%) amino acid sequence identity" with respect to a reference polypeptide sequence is defined as the percentage of amino acid residues in a candidate sequence that are identical with amino acid residues in a reference polypeptide sequence, after aligning the candidate sequence with the reference polypeptide sequence and introducing gaps, if necessary, to achieve the maximum percent sequence identity, and without regard to any conservative substitutions as part of the sequence identity. Alignments to determine percent amino acid sequence identity can be performed in a variety of ways within the skill in the art, for example, using publicly available computer software such as BLAST, BLAST-2, ALIGN, or Megalign (DNASTAR) software. One skilled in the art can determine appropriate parameters for aligning the sequences, including any algorithms necessary to achieve maximum alignment over the full length of the sequences being compared. However, for purposes herein, the sequence comparison computer program ALIGN-2 is used to generate values for% amino acid sequence identity. The ALIGN-2 sequence comparison computer program was written by Genentech, inc and the source code has been submitted with the user document to u.s.copy Office, washington d.c.,20559, where it was registered with us copyright registration number TXU 510087. The ALIGN-2 program is publicly available from Genettech, inc., south San Francisco, california, or may be compiled from this source code. The ALIGN-2 program should be compiled for use on a UNIX operating system, which includes the digital UNIX V4.0D. All sequence comparison parameters were set by the ALIGN-2 program and were unchanged.
In the case of amino acid sequence comparisons using ALIGN-2, the% amino acid sequence identity (which may alternatively be expressed as a percentage of the amino acid sequence identity of a given amino acid sequence A with or including a given amino acid sequence B) of a given amino acid sequence A to a given amino acid sequence B is calculated as follows:
100 times a fraction X/Y
Wherein X is the number of amino acid residues scored by the sequence alignment program ALIGN-2 as an identical match in an alignment of the program to A and B, and wherein Y is the total number of amino acid residues in B. It will be appreciated that where the length of amino acid sequence A is not equal to the length of amino acid sequence B, the% amino acid sequence identity of A to B will not be equal to the% amino acid sequence identity of B to A. Unless otherwise specifically indicated, all values of% amino acid sequence identity as used herein are obtained using the ALIGN-2 computer program as described in the preceding paragraph.
The term "pharmaceutical formulation" refers to a formulation that is in a form that allows for the biological activity of the active ingredient contained therein to be effective, and that is free of additional components having unacceptable toxicity to the subject to which the formulation is to be administered.
By "pharmaceutically acceptable carrier" is meant a component of a pharmaceutical formulation that is not toxic to the subject except for the active ingredient. Pharmaceutically acceptable carriers include, but are not limited to, buffers, excipients, stabilizers, or preservatives.
The terms "programmed death ligand 1" and "PD-L1" refer herein to native sequence PD-L1 polypeptides, polypeptide variants, and fragments of native sequence polypeptides and polypeptide variants (as further defined herein). The PD-L1 polypeptides described herein can be isolated from a variety of sources, such as from human tissue types or other sources, or made by recombinant or synthetic methods.
By "PD-L1 polypeptide variant" or variant thereof is meant a PD-L1 polypeptide (typically an active PD-L1 polypeptide) as defined herein that has at least about 80% amino acid sequence identity to any one of the native sequence PD-L1 polypeptide sequences as disclosed herein. Such PD-L1 polypeptide variants include, for example, PD-L1 polypeptides in which one or more amino acid residues are added or deleted at the N-terminus or C-terminus of the native amino acid sequence. Typically, a PD-L1 polypeptide variant will have at least about 80% amino acid sequence identity, or at least about 81%, 82%, 83%, 84%, 85%, 86%, 87%, 88%, 89%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, or 99% amino acid sequence identity, to a native sequence PD-L1 polypeptide sequence disclosed herein. Typically, a PD-L1 variant polypeptide is at least about 10 amino acids in length, alternatively at least about 20, 30, 40, 50, 60, 70, 80, 90, 100, 110, 120, 130, 140, 150, 160, 170, 180, 190, 200, 210, 220, 230, 240, 250, 260, 270, 280, 281, 282, 283, 284, 285, 286, 287, 288, 289 amino acids or more. Optionally, the PD-L1 variant polypeptide will have no more than one conservative amino acid substitution as compared to the native PD-L1 polypeptide sequence, or will contain no more than 2, 3, 4, 5, 6, 7, 8, 9, or 10 conservative amino acid substitutions as compared to the native PD-L1 polypeptide sequence.
A "native sequence PD-L1 polypeptide" comprises a polypeptide having the same amino acid sequence as a corresponding PD-L1 polypeptide derived from nature.
The term "PD-L1 axis binding antagonist" refers to a molecule that inhibits the interaction of a PD-L1 axis binding partner with its one or more binding partners to eliminate T cell dysfunction caused by signaling on the PD-1 signaling axis, resulting in restoration or enhancement of T cell function. As used herein, PD-L1 axis binding antagonists include PD-L1 binding antagonists and PD-1 binding antagonists as well as molecules that interfere with the interaction between PD-L1 and PD-1 (e.g., PD-L2-Fc fusions).
The term "PD-L1 binding antagonist" refers to a molecule that reduces, blocks, inhibits, eliminates or interferes with signaling resulting from the interaction of PD-L1 with one or more of its binding partners (such as PD-1 or B7-1). In some embodiments, the PD-L1 binding antagonist is a molecule that inhibits the binding of PD-L1 to its binding partner. In particular aspects, the PD-L1 binding antagonist inhibits the binding of PD-L1 to PD-1 and/or B7-1. In some embodiments, PD-L1 binding antagonists include anti-PD-L1 antibodies, antigen-binding fragments thereof, immunoadhesins, fusion proteins, oligopeptides, and others that reduce, block, inhibit, eliminate, or interfere with signaling resulting from the interaction of PD-L1 with one or more of its binding partners (such as PD-1 or B7-1). In one embodiment, the PD-L1 binding antagonist can reduce a negative costimulatory signal mediated by or through PD-L1 signaling mediated by a cell surface protein expressed on the T lymphocyte, thereby rendering the dysfunctional T cell less dysfunctional (e.g., increasing effector response to antigen recognition). In some embodiments, the PD-L1 binding antagonist is an anti-PD-L1 antibody. In a particular embodiment, the anti-PD-L1 antibody is atelizumab (CAS registry No. 1422185-06-5), also known as MPDL3280A, and as described herein. In another specific embodiment, the anti-PD-L1 antibody is yw243.55.S70 described herein. In another specific embodiment, the anti-PD-L1 antibody is MDX-1105 as described herein. In yet another specific aspect, the anti-PD-L1 antibody is MEDI4736 (dewalumab), as described herein. In yet another specific aspect, the anti-PD-L1 antibody is MSB0010718C (avizumab), as described herein.
As used herein, the term "PD-1 binding antagonist" refers to a molecule that reduces, blocks, inhibits, eliminates, or interferes with signaling resulting from the interaction of PD-1 with one or more of its binding partners (such as PD-L1 and/or PD-L2). In some embodiments, the PD-1 binding antagonist is a molecule that inhibits the binding of PD-1 to its binding partner. In particular aspects, the PD-1 binding antagonist inhibits the binding of PD-1 to PD-L1 and/or PD-L2. For example, PD-1 binding antagonists include anti-PD-1 antibodies and antigen-binding fragments thereof, immunoadhesins, fusion proteins, oligopeptides, small molecule antagonists, polynucleotide antagonists, and others that reduce, block, inhibit, eliminate, or otherwise interfere with signaling resulting from the interaction of PD-1 with PD-L1 and/or PD-L2. In one embodiment, the PD-1 binding antagonist reduces negative signals mediated (by PD-1 or PD-L1 mediated signaling) by or through cell surface proteins expressed on T lymphocytes or other cells, thereby resulting in reduced dysfunctional T cell dysfunction. In some embodiments, the PD-1 binding antagonist is an anti-PD-1 antibody. In a particular aspect, the PD-1 binding antagonist is MDX-1106 (nivolumab). In another specific aspect, the PD-1 binding antagonist is MK-3475 (pembrolizumab). In another specific aspect, the PD-1 binding antagonist is MEDI-0680 (AMP-514). In another specific aspect, the PD-1 binding antagonist is PDR001. In another specific aspect, the PD-1 binding antagonist is REGN2810. In another particular aspect, the PD-1 binding antagonist is BGB-108. In another specific aspect, the PD-1 binding antagonist is AMP-224.
"Polynucleotide" or "nucleic acid" are used interchangeably herein to refer to a polymer of nucleotides of any length and include DNA and RNA. A nucleotide may be a deoxyribonucleotide, a ribonucleotide, a modified nucleotide or base, and/or an analog thereof, or any substrate that can be incorporated into a polymer by a DNA or RNA polymerase or by a synthetic reaction. Polynucleotides may comprise modified nucleotides, such as methylated nucleotides and analogs thereof. If present, the nucleotide structure may be modified before or after assembly of the polymer. The sequence of nucleotides may be interrupted by non-nucleotide components. The polynucleotide may be further modified after synthesis, for example by conjugation with a label. Other types of modifications include, for example, "capping," replacing one or more of the naturally occurring nucleotides with similar internucleotide modifications, such as, for example, those having uncharged bonds (e.g., methyl phosphates, phosphotriesters, phosphoramidates, carbamates) and having charged bonds (e.g., phosphorothioates, phosphorodithioates, etc.), those containing pendant groups, such as, for example, proteins (e.g., nucleases, toxins, antibodies, signal peptides, ply-L-lysine, etc.), those containing intercalators (e.g., acridine, psoralen, etc.), those containing chelators (e.g., metals, radioactive metals, boron, oxidative metals, etc.), those containing alkylating agents, those having modified bonds (e.g., alpha anomeric nucleic acids, etc.), and unmodified forms of the polynucleotide. In addition, any hydroxyl group typically present in a sugar may be replaced (e.g., phosphate group), protected by a standard protecting group, or activated to make additional linkages to additional nucleotides, or may be conjugated to a solid or semi-solid support. The 5 'and 3' terminal OH groups may be phosphorylated or partially substituted with an amine or organic end-capping group of 1-20 carbon atoms. Other hydroxyl groups may also be derivatized as standard protecting groups. Polynucleotides may also comprise similar forms of ribose or deoxyribose as are generally known in the art, including, for example, 2 '-O-methyl-, 2' -O-allyl, 2 '-fluoro-or 2' -azido-ribose, carbocyclic sugar analogs, α -anomeric sugars, epimeric sugars (such as arabinose, xylose, or lyxose, pyranose, furanose, heptaheptose), acyclic analogs, and abasic nucleoside analogs such as methyl riboside. One or more phosphodiester linkages may be replaced by alternative linking groups. These alternative linking groups include, but are not limited to, embodiments in which the phosphate is replaced by P (O) S ("thioester"), P (S) S ("dithioate"), (O) NR2 ("amidate"), P (O) R, P (O) OR ', CO, OR CH2 ("methylal"), where each R OR R' is independently H OR a substituted OR unsubstituted alkyl (1-20C) optionally containing an ether (-O-) bond, aryl, alkenyl, cycloalkyl, cycloalkenyl, OR aralkyl (araldyl). Not all linkages in a polynucleotide need be identical. The foregoing description applies to all polynucleotides referred to herein, including RNA and DNA.
As used herein, "polymerase chain reaction" or "PCR" techniques generally refer to the procedure for amplifying minute quantities of a particular nucleic acid, RNA and/or DNA fragment as described in U.S. patent No. 4,683,195, issued on 28/7/1987. Generally, it is desirable to obtain sequence information from the end of the region of interest or from regions other than the end so that oligonucleotide primers can be designed; these primers are identical or similar in sequence to opposite strands of the template to be amplified. The 5' terminal nucleotides of the two primers may coincide with the ends of the amplified material. PCR can be used to amplify specific RNA sequences and specific DNA sequences from total genomic DNA, as well as cDNA transcribed from total cellular RNA, phage or plasmid sequences, and the like. See generally Mullis et al, cold Spring Harbor symp. Quant.biol.,51 (1987); erlich, eds, PCR Technology (Stockton Press, NY, 1989). As used herein, PCR is considered to be one, but not the only example, of a nucleic acid polymerase reaction method for amplifying a nucleic acid test sample, including the use of known nucleic acids (DNA or RNA) as primers and the use of a nucleic acid polymerase to amplify or generate a particular nucleic acid fragment, or to amplify or generate a particular nucleic acid fragment that is complementary to a particular nucleic acid.
As used herein, the term "reverse transcriptase polymerase chain reaction" or "RT-PCR" refers to the replication and amplification of RNA sequences. In this method, for example, reverse transcription is coupled to PCR as described in U.S. patent No. 5,322,770, which is incorporated by reference herein in its entirety. In RT-PCR, an RNA template is converted to cDNA due to the reverse transcriptase activity of the enzyme, and then amplified using the polymerization activity of the same or a different enzyme. Thermostable and thermolabile reverse transcriptases and polymerases may be used. "reverse transcriptase" (RT) may include reverse transcriptases from retroviruses, other viruses, and DNA polymerases that exhibit reverse transcriptase activity.
As used herein, the term "reverse transcriptase quantitative polymerase chain reaction" or "RT-qPCR" is a form of PCR in which the nucleic acid to be amplified is RNA that is first reverse transcribed into cDNA, and the amount of PCR product is measured in each step of the PCR reaction.
"quantitative real-time polymerase chain reaction" or "qRT-PCR" refers to a form of PCR in which the amount of PCR product is measured in each step of the PCR reaction. In the classes including Cronin et al, am.J.Pathol.164 (1): 35-42 (2004); and Ma et al, cancer Cell 5, 607-616 (2004).
The term "multiplex PCR" refers to a single PCR reaction performed on nucleic acids obtained from a single source (e.g., an individual) using more than one primer set, with the aim of amplifying two or more DNA sequences in a single reaction.
The term "RNA-seq," also known as "Whole Transcriptome Shotgun Sequencing (WTSS)," refers to sequencing and/or quantifying cDNA using high-throughput sequencing techniques to obtain information about the RNA content of a sample. Publications describing RNA-seq include: wang et al, nature Reviews Genetics 10 (1): 57-63 (2009); ryan et al, bioTechniques 45 (1): 81-94 (2008); and Maher et al, nature 458 (7234): 97-101 (2009).
The term "polynucleotide" when used in the singular or plural generally refers to any polyribonucleotide or polydeoxyribonucleotide, which may be unmodified RNA or DNA or modified RNA or DNA. Thus, for example, polynucleotides as defined herein include, but are not limited to: single-stranded and double-stranded DNA; DNA comprising single-stranded and double-stranded regions; single-and double-stranded RNA; RNA comprising single-stranded and double-stranded regions; and hybrid molecules comprising DNA and RNA (which may be single-stranded, or more typically double-stranded, or comprise single-and double-stranded regions). Furthermore, the term "polynucleotide" as used herein refers to a triple-stranded region comprising RNA or DNA or both RNA and DNA. The chains in such regions may be from the same molecule or from different molecules. A region may comprise all of one or more of the molecules, but typically comprises only one region of a portion of the molecule. One of the molecules having a triple-helical region is typically an oligonucleotide. The term "polynucleotide" specifically includes cDNA. The term includes DNA (including cDNA) and RNA that contain one or more modified bases. Thus, a DNA or RNA having a backbone modified for stability or other reasons is a "polynucleotide" as described herein. In addition, the term "polynucleotide" as defined herein includes DNA or RNA containing unusual bases (such as inosine) or modified bases (such as tritiated bases). In general, the term "polynucleotide" encompasses all chemically, enzymatically and/or metabolically modified forms of unmodified polynucleotides, as well as chemical forms of DNA and RNA that are characteristic of viruses and cells, including simple and complex cells.
Any endpoint that is indicated to be beneficial to an individual can be used to assess "response to treatment," "responsiveness to treatment," or "benefit from treatment," including but not limited to (1) inhibition of disease progression (e.g., cancer progression) to some extent, including slowing and complete arrest; (2) reducing tumor size; (3) Inhibit (i.e., reduce, slow, or completely stop) cancer cell infiltration into adjacent peripheral organs and/or tissues; (4) Inhibit (i.e., reduce, slow, or completely stop) metastasis; (5) Alleviating, to some extent, one or more symptoms associated with the disease or condition (e.g., cancer); (6) Increased or prolonged survival, including overall survival (OS HR < 1) and progression-free survival (PFS HR < 1); and/or (9) reduce mortality at a given time point following treatment (e.g., treatment comprising a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)). As used herein, a patient that is "non-responsive" to a particular form of treatment refers to a patient that fails to exhibit any or all of the above-described benefits after administration of a targeted therapy.
As used herein, "progression-free survival" or "PFS" refers to the length of time during and after treatment during which the disease being treated (e.g., cancer, such as lung cancer (e.g., NSCLC, including non-squamous NSCLC and squamous NSCLC), bladder cancer (e.g., UC), renal cancer (e.g., RCC), or breast cancer (e.g., TNBC)) does not progress or worsen. Progression-free survival can include the amount of time an individual experiences a complete response or a partial response, as well as the amount of time an individual experiences stable disease.
As used herein, "overall survival" or "OS" refers to the length of time a subject is likely to survive during and after treatment for a particular period of time (e.g., 6 months, 1 year, 2 years, 3 years, 4 years, 5 years, 10 years, 15 years, 20 years, or more than 20 years from diagnosis or treatment initiation).
As used herein, "complete response" or "CR" refers to the disappearance of all signs of cancer in response to treatment. This does not necessarily mean that the cancer has already cured.
As used herein, "partial response" or "PR" refers to a reduction in the size of one or more tumors or lesions or a reduction in the extent of cancer in vivo in response to treatment.
As used herein, "risk ratio" or "HR" is a statistical definition of the rate of occurrence of an event. For the purposes of the present invention, a risk ratio is defined as representing the probability of an event (e.g., PFS or OS) in an experimental (e.g., treatment) group (group)/cohort (arm) divided by the probability of an event in a control group (group)/cohort (arm) at any particular point in time. An HR value of 1 indicates that the relative risk (e.g., death) of the endpoint is equal in both the "treatment" group and the "control" group; a value greater than 1 indicates a greater risk in the treated group relative to the control group; a value less than 1 indicates a greater risk for the control group relative to the treated group. The "risk ratio" in the progression-free survival analysis (i.e. PFS HR) summarizes the difference between the two progression-free survival curves, representing a reduced risk of mortality for the treatment compared to the control over the follow-up period. The "risk ratio" in the overall survival analysis (i.e. OS HR) summarizes the difference between the two overall survival curves, representing a reduced risk of mortality for the treatment compared to the control over the follow-up period.
By "extended survival" or "extension of survival" is meant an increase in the overall survival or progression-free survival of a treated individual relative to an untreated individual (i.e., relative to an individual not treated with a drug) or relative to an individual not expressing a specified level of a biomarker and/or relative to an individual treated with an approved anti-neoplastic agent. Objective response refers to a measurable response, including Complete Response (CR) or Partial Response (PR).
By "reduce or inhibit" is meant the ability to cause an overall decrease of 20%, 30%, 40%, 50%, 60%, 70%, 75%, 80%, 85%, 90%, 95% or more. Reduced or inhibited can refer to the symptoms of a condition being treated (e.g., cancer, such as lung cancer (e.g., NSCLC, including non-squamous NSCLC and squamous NSCLC), bladder cancer (e.g., UC), renal cancer (e.g., RCC), or breast cancer (e.g., TNBC)), the presence or size of a metastatic tumor, or the size of a primary tumor.
As used herein, "reference sample," "reference cell," "reference tissue," "control sample," "control cell," or "control tissue" refers to a sample, cell, tissue, standard, or level for purposes of comparison. In one embodiment, the reference sample, reference cell, reference tissue, control sample, control cell, or control tissue is obtained from the same subject or individual. In another embodiment, the reference sample is obtained from one or more individuals that are not subjects or individuals. In any of the preceding embodiments, one or more individuals from whom the reference sample, reference cell, reference tissue, control sample, control cell, or control tissue is obtained have cancer. In certain embodiments, one or more individuals from whom the reference sample, reference cells, reference tissue, control sample, control cells, or control tissue is obtained have cancer and have been previously treated with an anti-cancer therapy (e.g., one or more doses of a PD-L1 axis binding antagonist). In other embodiments, one or more individuals from whom the reference sample, reference cell, reference tissue, control sample, control cell, or control tissue is obtained have cancer and are untreated. In any of the preceding embodiments, the subject/individual and one or more individuals that are not the subject or individual have the same cancer. In yet another embodiment, the reference sample, reference cell, reference tissue, control sample, control cell, or control tissue is obtained from a healthy and/or non-diseased body part (e.g., tissue or cell) of the same subject or individual. For example, healthy and/or non-diseased cells or tissues adjacent to a diseased cell or tissue (e.g., cells or tissues adjacent to a tumor). In another embodiment, the reference sample is obtained from untreated tissue and/or cells of the body of the same subject or individual. In yet another embodiment, the reference sample, reference cell, reference tissue, control sample, control cell, or control tissue is obtained from a healthy and/or non-diseased portion (e.g., tissue or cell) of the body of an individual that is not the subject or individual. In yet another embodiment, the reference sample, reference cell, reference tissue, control sample, control cell, or control tissue is obtained from untreated tissue and/or cells that are not part of the individual's body of the subject or individual.
As used herein, the term "sample" refers to a composition obtained or derived from a subject and/or individual of interest that comprises, for example, cells and/or other molecular entities to be characterized and/or identified based on physical, biochemical, chemical, and/or physiological characteristics. For example, the phrase "disease sample" and variations thereof refers to any sample obtained from a subject of interest that is expected or known to comprise the cellular and/or molecular entities to be characterized. Samples include, but are not limited to, primary or cultured cells or cell lines, cell supernatants, cell lysates, platelets, serum, plasma, vitreous humor, lymph fluid, synovial fluid, follicular fluid, semen, amniotic fluid, milk, whole blood, blood-derived cells, urine, cerebrospinal fluid, saliva, sputum, tears, sweat, mucus, tumor lysate and tissue culture medium, tissue extracts such as homogenized tissue, tumor tissue, cell extracts, and combinations thereof.
As used herein, the terms "individual," "patient," and "subject" are used interchangeably and refer to any single animal, more preferably a mammal (including, e.g., non-human animals, e.g., cats, dogs, horses, rabbits, zoo animals, cows, pigs, sheep, and non-human primates), in need of treatment. In certain embodiments, the individual, patient, or subject is a human.
As used herein, "treatment" (and grammatical variations thereof, such as "treatment" or "treating") refers to a clinical intervention that attempts to alter the natural course of the subject to be treated, and may be for the purpose of prophylaxis or in the course of clinical pathology. Desirable therapeutic effects include, but are not limited to, preventing the onset or recurrence of a disease (e.g., cancer, such as lung cancer (e.g., NSCLC, including non-squamous NSCLC and squamous NSCLC), bladder cancer (e.g., UC), renal cancer (e.g., RCC), or breast cancer (e.g., TNBC)), alleviating symptoms, alleviating any direct or indirect pathological consequences of the disease, preventing metastasis, reducing the rate of disease progression, improving or mitigating a condition, and alleviating or improving prognosis. In some embodiments, the treatment described herein is used to delay the progression or slow the progression of a disease (e.g., cancer, such as lung cancer (e.g., NSCLC, including non-squamous NSCLC and squamous NSCLC), bladder cancer (e.g., UC), renal cancer (e.g., RCC), or breast cancer (e.g., TNBC)). In some cases, treatment may increase Overall Survival (OS) (e.g., by about 20% or more, about 25% or more, about 30% or more, about 35% or more, about 40% or more, about 45% or more, about 50% or more, about 55% or more, about 60% or more, about 65% or more, about 70% or more, about 75% or more, about 80% or more, about 85% or more, about 90% or more, about 95% or more, about 96% or more, about 97% or more, about 98% or more, or about 99% or more). In some cases, treatment may increase OS, e.g., by about 5% to about 500%, e.g., about 10% to about 450%, e.g., about 20% to about 400%, e.g., about 25% to about 350%, e.g., about 30% to about 400%, e.g., about 35% to about 350%, e.g., about 40% to about 300%, e.g., about 45% to about 250%, e.g., about 50% to about 200%, e.g., about 55% to about 150%, e.g., about 60% to about 100%, e.g., about 65% to about 100%, e.g., about 70% to about 100%, e.g., about 75% to about 100%, e.g., about 80% to about 100%, e.g., about 85% to about 100%, e.g., about 90% to about 100%, e.g., about 95% to about 100%, e.g., about 98% to about 100%. In some cases, treatment may increase progression-free survival (PFS) (e.g., an increase of about 20% or more, about 25% or more, about 30% or more, about 35% or more, about 40% or more, about 45% or more, about 50% or more, about 55% or more, about 60% or more, about 65% or more, about 70% or more, about 75% or more, about 80% or more, about 85% or more, about 90% or more, about 95% or more, about 96% or more, about 97% or more, about 98% or more, or about 99% or more). In some cases, treatment may increase PFS, e.g., by about 5% to about 500%, e.g., about 10% to about 450%, e.g., about 20% to about 400%, e.g., about 25% to about 350%, e.g., about 30% to about 400%, e.g., about 35% to about 350%, e.g., about 40% to about 300%, e.g., about 45% to about 250%, e.g., about 50% to about 200%, e.g., about 55% to about 150%, e.g., about 60% to about 100%, e.g., about 65% to about 100%, e.g., about 70% to about 100%, e.g., about 75% to about 100%, e.g., about 80% to about 100%, e.g., about 85% to about 100%, e.g., about 90% to about 100%, e.g., about 95% to about 100%, e.g., about 98% to about 100%.
"tissue sample" or "cell sample" refers to a collection of similar cells obtained from a tissue of a subject or individual. The source of the tissue or cell sample may be solid tissue from fresh, frozen and/or preserved organs, tissue samples, biopsies and/or aspirates; blood or any blood component, such as plasma; body fluids, such as cerebrospinal fluid, amniotic fluid, peritoneal fluid, or interstitial fluid; cells at any time during pregnancy or development of the subject. The tissue sample may also be primary or cultured cells or cell lines. Optionally, the tissue or cell sample is obtained from a disease (e.g., cancer, e.g., lung cancer (e.g., NSCLC, including non-squamous NSCLC and squamous NSCLC), bladder cancer (e.g., UC), renal cancer (e.g., RCC), or breast cancer (e.g., TNBC)) tissue/organ. Tissue samples may contain compounds that do not naturally mix with tissue in the natural environment, such as preservatives, anticoagulants, buffers, fixatives, nutrients, antibiotics, and the like.
For purposes herein, a "section" of a tissue sample refers to a single portion or piece of the tissue sample, e.g., a thin slice of tissue or cells cut from the tissue sample. It is understood that multiple sections of a tissue sample may be taken and analyzed, provided that it is understood that the same section of a tissue sample may be analyzed at the morphological and molecular level, or may be analyzed for polypeptides and polynucleotides.
The terms "tertiary lymphoid structure" and "TLS" are used interchangeably herein and refer to ectopic lymphoid structures that may form in non-lymphoid tissues (e.g., at sites of chronic inflammation, including tumors). These terms may refer to structures of different tissues, for example, from lymphocyte clusters to isolated structures reminiscent of secondary lymphoid organs. For example, these terms encompass TLS-like structures. In some cases, TLS may comprise distinct T-cell and B-cell compartments, a Fibroblast Reticulocyte (FRC) network, peripheral lymph node addressin (PNAd) + ) Evidence of High Endothelial Venules (HEV), follicular Dendritic Cells (FDC), class switching and reactive Germinal Centers (GC) in the B cell region and/or activation-induced expression of cytidine deaminase (AID), an enzyme expressed in GC B cells involved in somatic hypermutation initiation and immunoglobulin gene class switching. For a review of TLS in cancer, see Colbeck et al front.Immunol.8:1830,2017.
As used herein, the term "tumor" refers to all neoplastic cell growth and proliferation, whether malignant or benign, and all pre-cancerous and cancerous cells and tissues. The terms "cancer," "cancerous," "cell proliferative disorder," "proliferative disorder," and "tumor" are not mutually exclusive herein.
The term "variable region" or "variable domain" refers to the domain of an antibody heavy or light chain that is involved in binding of the antibody to an antigen. The variable domains of the heavy and light chains of natural antibodies (VH and VL, respectively) generally have a similar structure, with each domain containing four conserved Framework Regions (FR) and three hypervariable regions (HVRs). (see, e.g., kindt et al, kuby Immunology, 6 th edition, w.h.freeman and co., page 91 (2007)) a single VH or VL domain may be sufficient to confer antigen binding specificity. Furthermore, antibodies that bind a particular antigen can be isolated using the VH or VL domains, respectively, from antibodies that bind the antigen to screen libraries of complementary VL or VH domains. See, e.g., portolano et al, J.Immunol.150:880-887 (1993); clarkson et al, nature 352, 624-628 (1991).
Diagnostic method
Provided herein are methods for identifying individuals having cancer (e.g., lung cancer (e.g., non-small cell lung cancer (NSCLC)), bladder cancer (e.g., urothelial Cancer (UC)), kidney cancer (e.g., renal Cell Carcinoma (RCC)) or breast cancer (e.g., triple Negative Breast Cancer (TNBC)) that may benefit from treatment comprising a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., an atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
Further provided herein are methods for selecting a therapy for an individual having cancer (e.g., lung cancer (e.g., NSCLC), bladder cancer (e.g., UC), renal cancer (e.g., RCC), or breast cancer (e.g., TNBC)); a method for determining whether an individual having cancer is likely to respond to treatment comprising a PD-L1 axis binding antagonist; a method for predicting responsiveness of an individual having cancer to a binding antagonist comprising the PD-L1 axis; and methods of monitoring the response of an individual having cancer to a treatment regimen comprising a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
Any of the methods provided herein can comprise determining the presence and/or expression level of any of the biomarkers disclosed herein. For example, a biomarker may comprise the presence and/or level of expression of a biomarker listed in any one of tables 1 to 17 below in a sample obtained from an individual; the presence of TLS in a sample obtained from an individual; the number of B cells in a sample obtained from an individual; the case of clonally expanded B cells in a sample from an individual; and/or combinations thereof. Any suitable sample may be used, for example, any sample type disclosed herein, including tumor samples.
Any of the methods provided herein can further comprise selecting a therapy for the individual, such as a therapy comprising a PD-L1 axis binding antagonist (e.g., as described below in section IV).
Any of the methods provided herein can further comprise administering to the individual a separate PD-L1 axis binding antagonist (e.g., as described in section IV below).
Table 1: exemplary biomarkers
CD79A
SLAMF7
BTK
TNFRSF17
IGJ
IGLL5
RBPJ
MZB1
CCL2
CCL3
CCL4
CCL5
CCL8
CCL18
CCL19
CCL21
CXCL9
CXCL10
CXCL11
CXCL13
For example, provided herein is a method of identifying an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) who is likely to benefit from treatment comprising a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attrituzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)), the method comprising determining, in a sample from the individual, the expression levels of one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, or 20) genes listed in table 1, wherein the individual is likely to benefit from identification of the PD axis binding antagonist in the event that the immune score expression level of the one or more genes is higher than a reference immune expression level of the one or more genes.
In another example, provided herein is a method of selecting a therapy for an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising determining the expression level of one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, or 20) of the genes listed in table 1 in a sample from the individual, wherein the individual is identified as likely to benefit from treatment with a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., attritol antagonist) or a PD-1 binding antagonist (e.g., an anti-PD 1 antibody)), where the immune score expression level of the one or more genes is higher than a reference immune score expression level of the one or more genes.
In some cases, the immune score expression level of one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, or 20) genes in the sample is greater than the reference immune score expression level, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attritumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)). Any suitable PD-L1 axis binding antagonist can be administered, e.g., any PD-L1 axis binding antagonist provided herein (e.g., as described in section IV below).
Any suitable immuno-score reference expression level can be used. In some cases, the immune score reference expression level is an immune score expression level of one or more genes in a reference population. In some cases, the reference population is a population of individuals with cancer. In some cases, the population of individuals includes a first subset of individuals who have received treatment with a PD-L1 axis binding antagonist and a second subset of individuals who have received treatment with a therapy that does not contain a PD-L1 axis binding antagonist. In some cases, the reference immune score expression level visibly differentiates each of the first subset of individuals from the second subset of individuals based on a significant difference between the individual's responsiveness to treatment with a PD-L1 axis binding antagonist and the individual's responsiveness to treatment with a therapy that does not contain a PD-L1 axis binding antagonist, above the reference immune score expression level, wherein the individual's responsiveness to treatment with a PD-L1 axis binding antagonist is significantly improved relative to the individual's responsiveness to treatment with a therapy that does not contain a PD-L1 axis binding antagonist. In some cases, the therapy without the PD-L1 axis binding antagonist comprises an anti-neoplastic agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, or a combination thereof. In some cases, the therapy without the PD-L1 axis binding antagonist comprises a chemotherapeutic agent. In some cases, the chemotherapeutic agent is docetaxel. In some cases, responsiveness to treatment comprises prolongation of OS, prolongation of progression-free survival (PFS), or an increase in the determined optimal overall response (BCOR). In some cases, responsiveness to treatment includes an extension of Overall Survival (OS). In some cases, the reference immune score expression level is the median of the expression levels of each of the one or more genes in the reference population. In some cases, the median expression level is the median of the mean Z scores for the expression levels of each of the one or more genes in the reference population.
Any suitable sample may be used. In some cases, the sample is a tissue sample, a cell sample, a whole blood sample, a plasma sample, a serum sample, or a combination thereof. In some cases, the tissue sample is a tumor tissue sample. In some cases, the tumor sample is a tumor tissue sample. In some cases, the tumor tissue sample comprises tumor cells, tumor infiltrating immune cells, stromal cells, NAT cells, or a combination thereof. In some cases, the tumor tissue sample is a formalin-fixed and paraffin-embedded (FFPE) sample, an archived sample, a fresh sample, or a frozen sample. In some cases, the tumor tissue sample is an FFPE sample.
The cancer may be any suitable type of cancer. In some cases, the cancer is lung cancer, kidney cancer, bladder cancer, breast cancer, colorectal cancer, ovarian cancer, pancreatic cancer, stomach cancer, esophageal cancer, mesothelioma, melanoma, head and neck cancer, thyroid cancer, sarcoma, prostate cancer, glioblastoma, cervical cancer, thymus cancer, leukemia, lymphoma, myeloma, mycosis fungoides, merkel cell carcinoma, or a hematological malignancy. In some cases, the cancer is lung, kidney, bladder, or breast cancer. In some cases, the lung cancer is non-small cell lung cancer (NSCLC). In some cases, the NSCLC is non-squamous NSCLC. In some cases, the NSCLC is squamous NSCLC.
In some cases, the benefit comprises a prolongation of OS in the individual, a prolongation of PFS in the individual, and/or an improvement in BCOR in the individual as compared to treatment without the PD-L1 axis binding antagonist. In some cases, the benefit includes a prolongation of OS in the individual as compared to treatment without the PD-L1 axis binding antagonist.
A.B cell characteristics
(i) Gene signature associated with B cells
In some aspects, the methods provided herein can involve determining the expression level of one or more genes in a B cell signature. Any suitable B cell characteristics may be used. For example, a B cell characteristic can include one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) genes listed in table 2.
Table 2: exemplary B cell signature genes
CD79A
CD19
BANK1
JCHAIN
SLAMF7
BTK
TNFRSF17
IGJ
IGLL5
RBPJ
MZB1
For example, provided herein is a method of identifying an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) who is likely to benefit from treatment comprising a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attrituzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)), the method comprising determining, in a sample from the individual, expression levels of one or more of genes CD79A, CD19, BANK1, jcain, SLAMF7, BTK TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) where an individual who is likely to benefit from identification of an immune expression level of the one or more genes that is higher than an immune expression level of the PD-L1 axis binding antagonist.
In another example, provided herein is a method of selecting a therapy for an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising determining the expression level of one or more of genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) in a sample from the individual, wherein the individual is identified as likely to benefit from treatment of the individual with a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 binding antibody, e.g., attritol 1-PD-binding antibody) or an anti-PD 1-bead antibody, e.g., anti-PD 1 monoclonal antibody).
In some cases, the method comprises determining the expression level of one of genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB 1.
In some cases, the method comprises determining the expression level of CD 79A.
In some cases, the method comprises determining the expression level of CD 19.
In some cases, the method comprises determining an expression level of BANK 1.
In some cases, the method comprises determining the expression level of JCHAIN.
In some cases, the method comprises determining the expression level of SLAMF 7.
In some cases, the method includes determining an expression level of BTK.
In some cases, the method comprises determining the expression level of TNFRSF 17.
In some cases, the method comprises determining the expression level of IGJ.
In some cases, the method includes determining the expression level of IGLL 5.
In some cases, the method comprises determining an expression level of RBPJ.
In some cases, the method comprises determining an expression level of MZB 1.
In some cases, the immune score expression level of one or more genes in the sample is greater than the reference immune score expression level, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)). Any suitable PD-L1 axis binding antagonist can be administered, e.g., any PD-L1 axis binding antagonist provided herein (e.g., as described in section IV below).
Any suitable immuno-score reference expression level can be used. In some cases, the immune score reference expression level is an immune score expression level of one or more genes in the reference population. In some cases, the reference population is a population of individuals with cancer. In some cases, the population of individuals includes a first subset of individuals who have received treatment with a PD-L1 axis binding antagonist and a second subset of individuals who have received treatment with a therapy that does not contain a PD-L1 axis binding antagonist. In some cases, the reference immune score expression level visibly differentiates each of the first subset of individuals from the second subset of individuals based on a significant difference between the individual's responsiveness to treatment with a PD-L1 axis binding antagonist and the individual's responsiveness to treatment with a therapy that does not contain a PD-L1 axis binding antagonist, above the reference immune score expression level, wherein the individual's responsiveness to treatment with a PD-L1 axis binding antagonist is significantly improved relative to the individual's responsiveness to treatment with a therapy that does not contain a PD-L1 axis binding antagonist. In some cases, the therapy without the PD-L1 axis binding antagonist comprises an anti-neoplastic agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, or a combination thereof. In some cases, the therapy without the PD-L1 axis binding antagonist comprises a chemotherapeutic agent. In some cases, the chemotherapeutic agent is docetaxel. In some cases, responsiveness to treatment comprises prolongation of OS, prolongation of PFS, or an increase in BCOR. In some cases, responsiveness to treatment includes an extension of Overall Survival (OS). In some cases, the reference immune score expression level is the median of the expression levels of each of the one or more genes in the reference population. In some cases, the median expression level is the median of the mean Z scores for the expression levels of each of the one or more genes in the reference population.
For example, provided herein is a method of identifying an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) who may benefit from treatment comprising a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attrituzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)), the method comprising determining the expression levels of one or more of genes CD79A, CD19, BANK1, jcain, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) in a sample from the individual, wherein an individual who has a higher immune expression level than the reference gene or genes whose immune expression level would benefit from treatment comprises an extended PD-axis binding to the individual, wherein the subject's PD-1 would benefit from treatment using the antagonist.
In another example, provided herein is a method of selecting a therapy for an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising determining the expression level of one or more of genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, rbj, and MZB1 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) in a sample from the individual, wherein the individual is identified as likely to benefit from treatment with a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 binding antagonist, such as an attritol antibody) or an anti-PD 1 binding antibody, wherein the treatment does not include treatment of the individual with the PD-1 axis binding antagonist, such as an anti-PD 1 binding antagonist (e.g., an anti-PD 1) antibody, wherein the individual does not benefit from treatment with the anti-PD 1, such as an anti-PD-OS antagonist.
In some cases, the immune score expression level of one or more genes in the sample is higher than the reference immune score expression level, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)). Any suitable PD-L1 axis binding antagonist can be administered, e.g., any PD-L1 axis binding antagonist provided herein (e.g., as described in section IV below).
In some cases, the genes include two or more of CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB 1.
For example, provided herein is a method of identifying an individual having cancer who may benefit from treatment comprising a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)), the method comprising determining the expression level of two or more of genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 (e.g., 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) in a sample from the individual, wherein the individual is identified as a treated individual who may comprise a PD-L1 axis binding antagonist if the immune score expression level of the two or more genes is higher than the reference immune score expression level of the two or more genes.
In another example, provided herein is a method of selecting a therapy for an individual having cancer, the method comprising determining the expression level of two or more (e.g., 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual, wherein the individual is identified as an individual likely to benefit from treatment comprising a PD-L1 axis binding antagonist if the immune score expression level of the two or more genes is greater than a reference immune score expression level of the two or more genes.
In another example, provided herein is a method of identifying an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) who may benefit from treatment with a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attrituximab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) comprising determining expression levels of two or more of genes CD79A, CD19, BANK1, jcain, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 (e.g., 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) in a sample from the individual, wherein an immune expression level of the two or more genes is higher than an immune expression level of the two or more genes, wherein the identification of the PD-L axis binding antagonist is included in the individual who may benefit from treatment with prolonged PD-1 axis binding.
In yet another example, provided herein is a method of selecting a therapy for an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising determining the expression level of two or more (e.g., 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) of genes CD79A, CD19, BANK1, jcain, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, rbj, and MZB1 in a sample from the individual, wherein the individual is identified as likely to benefit from treatment with a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antagonist, e.g., attritrin) or an anti-PD 1 binding antagonist, wherein the treatment of the individual does not comprise prolonged PD-1 axis binding of the PD-OS treatment.
In some cases, the immune score expression level of two or more genes in the sample is higher than the reference immune score expression level, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)). Any suitable PD-L1 axis binding antagonist can be administered, e.g., any PD-L1 axis binding antagonist provided herein (e.g., as described in section IV below).
Any combination of B cell signature genes can be determined. For example, the combination may include two genes selected from CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1, e.g., any one of the combinations listed in table 3. In another example, the combination can include three genes selected from CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1, e.g., any one of the combinations listed in table 4. In another example, the combination can include four genes selected from CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1, e.g., any one of the combinations listed in table 5. In another example, the combination may include five genes selected from CD79A, CD19, BANK1, jchan, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1, e.g., any one of the combinations listed in table 6. In another example, the combination can include six genes selected from CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1, e.g., any one of the combinations listed in table 7. In another example, the combination may include seven genes selected from CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1, e.g., any one of the combinations listed in table 8.
Table 3: exemplary two-Gene combinations of B-cell signature genes
Figure BDA0003990674580000841
Figure BDA0003990674580000851
Table 4: exemplary three-Gene combinations of B-cell signature genes
Figure BDA0003990674580000861
Figure BDA0003990674580000871
Figure BDA0003990674580000881
Table 5: exemplary four Gene combinations of B cell signature genes
Figure BDA0003990674580000882
Figure BDA0003990674580000891
Figure BDA0003990674580000901
Table 6: exemplary five-Gene combinations of B-cell signature genes
Figure BDA0003990674580000902
Figure BDA0003990674580000911
Figure BDA0003990674580000921
Table 7: exemplary six-Gene combinations of B cell signature genes
Figure BDA0003990674580000922
Figure BDA0003990674580000931
Figure BDA0003990674580000941
Table 8: exemplary seven Gene combinations of B cell signature genes
CD79A, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, and RBPJ
CD79A, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, and MZB1
CD79A, SLAMF7, BTK, TNFRSF17, IGJ, RBPJ, and MZB1
CD79A, SLAMF7, BTK, TNFRSF17, IGLL5, RBPJ, and MZB1
CD79A, SLAMF7, BTK, IGJ, IGLL5, RBPJ, and MZB1
CD79A, SLAMF7, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1
CD79A, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1
SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1
CD19, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, and RBPJ
CD19, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, and MZB1
CD19, SLAMF7, BTK, TNFRSF17, IGJ, RBPJ, and MZB1
CD19, SLAMF7, BTK, TNFRSF17, IGLL5, RBPJ, and MZB1
CD19, SLAMF7, BTK, IGJ, IGLL5, RBPJ, and MZB1
CD19, SLAMF7, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1
CD19, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1
BANK1, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, and RBPJ
BANK1, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, and MZB1
BANK1, SLAMF7, BTK, TNFRSF17, IGJ, RBPJ, and MZB1
BANK1, SLAMF7, BTK, TNFRSF17, IGLL5, RBPJ, and MZB1
BANK1, SLAMF7, BTK, IGJ, IGLL5, RBPJ, and MZB1
BANK1, SLAMF7, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1
BANK1, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1
JCHAIN、SLAMF7、BTK、TNFRSF17、IGJ、IGLL5 and RBPJ
JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, and MZB1
JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, RBPJ, and MZB1
JCHAIN, SLAMF7, BTK, TNFRSF17, IGLL5, RBPJ, and MZB1
JCHAIN, SLAMF7, BTK, IGJ, IGLL5, RBPJ, and MZB1
JCHAIN, SLAMF7, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1
JCHAIN, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1
In some cases, the genes include CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1.
In some cases, the expression level is a nucleic acid expression level. For example, in some cases, the nucleic acid expression level is an mRNA expression level. mRNA expression levels can be determined using any suitable method (e.g., any method disclosed herein). In some cases, mRNA expression levels are determined by RNA-seq, RT-qPCR, multiplex qPCR or RT-qPCR, microarray analysis, SAGE, massARRAY technology, FISH, or combinations thereof. In some cases, mRNA expression levels are detected using RNA-seq.
In other cases, the expression level is a protein expression level. Protein expression levels can be determined using any suitable method (e.g., any of the methods disclosed herein). In some cases, protein expression levels are determined by IHC, immunofluorescence, mass spectrometry, flow cytometry, and western blotting, or combinations thereof.
Any suitable sample may be used. In some cases, the sample is a tissue sample, a cell sample, a whole blood sample, a plasma sample, a serum sample, or a combination thereof. In some cases, the tissue sample is a tumor tissue sample. In some cases, the tumor sample is a tumor tissue sample. In some cases, the tumor tissue sample comprises tumor cells, tumor infiltrating immune cells, stromal cells, NAT cells, or a combination thereof. In some cases, the tumor tissue sample is an FFPE sample, an archived sample, a fresh sample, or a frozen sample. In some cases, the tumor tissue sample is an FFPE sample.
The cancer may be any suitable type of cancer. In some cases, the cancer is lung cancer, kidney cancer, bladder cancer, breast cancer, colorectal cancer, ovarian cancer, pancreatic cancer, gastric cancer, esophageal cancer, mesothelioma, melanoma, head and neck cancer, thyroid cancer, sarcoma, prostate cancer, glioblastoma, cervical cancer, thymus cancer, leukemia, lymphoma, myeloma, mycosis fungoides, merkel cell carcinoma, or hematological malignancy. In some cases, the cancer is lung, kidney, bladder, or breast cancer. In some cases, the lung cancer is NSCLC. In some cases, the NSCLC is non-squamous NSCLC. In some cases, the NSCLC is squamous NSCLC.
In some cases, the benefit comprises a prolongation of OS in the individual, a prolongation of PFS in the individual, and/or an improvement in BCOR in the individual as compared to treatment without the PD-L1 axis binding antagonist. In some cases, the benefit includes an extension of the Overall Survival (OS) of the individual as compared to treatment without the PD-L1 axis binding antagonist.
(ii) Gene signature associated with plasma B cells
In some aspects, the B cell characteristic used in conjunction with the compositions and methods of the present disclosure is a plasma B cell characteristic. Any suitable plasma B cell characteristics may be used. For example, a plasma B cell characteristic can include one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, or 14) genes listed in table 9.
Table 9: exemplary plasma B cell signature genes
MZB1
DERL3
JSRP1
TNFRSF17
SLAMF7
IGHG2
IGHGP
IGLV3-1
IGLV6-57
IGHA2
IGKV4-1
IGKV1-12
IGLC7
IGLL5
For example, provided herein is a method of identifying an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) who is likely to benefit from treatment comprising a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as astuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)), the method comprising determining in a sample from the individual one or more of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, or more of the genes are likely to be expressed at a high level in the individual, wherein the immune axis is expressed at a reference level that would benefit from treatment comprising expression of the individual at the reference level of the one or more of the individual.
In another example, provided herein is a method of selecting a therapy for an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising determining the expression level of one or more of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, or 14) in a sample from the individual, wherein the individual is likely to comprise an anti-PD antibody, e.g., an anti-PD 1-PD antibody, e.g., an anti-PD-1, or an anti-PD antagonist.
In some cases, the method includes determining an expression level of one of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
In some cases, the method comprises determining an expression level of MZB 1.
In some cases, the method comprises determining an expression level of DERL 3.
In some cases, the method comprises determining an expression level of JSRP 1.
In some cases, the method comprises determining the expression level of TNFRSF 17.
In some cases, the method includes determining the expression level of SLAMF 7.
In some cases, the method comprises determining the expression level of IGHG 2.
In some cases, the method comprises determining the expression level of IGHGP.
In some cases, the method comprises determining the expression level of IGLV 3-1.
In some cases, the method comprises determining the expression level of IGLV 6-57.
In some cases, the method comprises determining the expression level of IGHA 2.
In some cases, the method includes determining the expression level of IGKV 4-1.
In some cases, the method includes determining the expression level of IGKV 1-12.
In some cases, the method comprises determining the expression level of IGLC 7.
In some cases, the method includes determining the expression level of IGLL 5.
In some cases, the immune score expression level of one or more genes in the sample is greater than the reference immune score expression level, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)). Any suitable PD-L1 axis binding antagonist can be administered, e.g., any PD-L1 axis binding antagonist provided herein (e.g., as described in section IV below).
Any suitable immuno-score reference expression level can be used. In some cases, the immune score reference expression level is an immune score expression level of one or more genes in the reference population. In some cases, the reference population is a population of individuals with cancer. In some cases, the population of individuals includes a first subset of individuals who have received treatment with a PD-L1 axis binding antagonist and a second subset of individuals who have received treatment with a therapy that does not contain a PD-L1 axis binding antagonist. In some cases, the reference immune score expression level visibly differentiates each of the first subset of individuals from the second subset of individuals based on a significant difference between the individual's responsiveness to treatment with a PD-L1 axis binding antagonist and the individual's responsiveness to treatment with a therapy that does not contain a PD-L1 axis binding antagonist, above the reference immune score expression level, wherein the individual's responsiveness to treatment with a PD-L1 axis binding antagonist is significantly improved relative to the individual's responsiveness to treatment with a therapy that does not contain a PD-L1 axis binding antagonist. In some cases, the therapy without the PD-L1 axis binding antagonist comprises an anti-tumor agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, or a combination thereof. In some cases, the therapy without the PD-L1 axis binding antagonist comprises a chemotherapeutic agent. In some cases, the chemotherapeutic agent is docetaxel. In some cases, responsiveness to treatment comprises a prolongation of OS, a prolongation of PFS, or an increase in BCOR. In some cases, responsiveness to treatment includes an extension of Overall Survival (OS). In some cases, the reference immune score expression level is the median of the expression levels of each of the one or more genes in the reference population. In some cases, the median expression level is the median of the mean Z scores for the expression levels of each of the one or more genes in the reference population.
For example, provided herein is a method of identifying an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) who may benefit from treatment comprising a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attrituzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)), the method comprising determining in a sample from the individual one or more of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 11, 13, or 13) in which the individual is likely to benefit from treatment using a high level of expression of the PD-L1, wherein the gene comprises an immune-1 or more of the antagonist.
In another example, provided herein is a method of selecting a therapy for an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), renal cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising determining the expression level of one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, or 14) of the genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 in a sample from the individual, wherein in the event that the immune score expression level of the one or more genes is greater than the reference immune score expression level of the one or more genes, identifying the individual as an individual likely to benefit from treatment comprising a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attritumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)), wherein the benefit comprises an increase in OS of the individual as compared to treatment without the PD-L1 axis binding antagonist.
In some cases, the immune score expression level of one or more genes in the sample is greater than the reference immune score expression level, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)). Any suitable PD-L1 axis binding antagonist can be administered, e.g., any PD-L1 axis binding antagonist provided herein (e.g., as described in section IV below).
In some cases, the genes include two or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
For example, provided herein is a method of identifying an individual having cancer who is likely to benefit from treatment comprising a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as astuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)), the method comprising determining the expression levels of two or more (e.g., 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, or 14) of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 in a sample from the individual, wherein the cases where the immune expression levels of the two or more genes are higher than a reference immune expression level of the two or more genes identify the individual as likely to benefit from treatment comprising a PD-L1 axis antagonist.
In another example, provided herein is a method of selecting a therapy for an individual having cancer, the method comprising determining the expression level of two or more (e.g., 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, or 14) of the genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 in a sample from the individual, wherein the individual is identified as an individual likely to benefit from treatment comprising a PD-L1 axis binding antagonist if the immune score expression level of the two or more genes is greater than a reference immune expression score level of the two or more genes.
In another example, provided herein is a method of identifying an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., NSCLC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) who may benefit from treatment comprising a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attrituzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)), the method comprising determining in a sample from the individual two or more of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, iguc 2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 (e.g., 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, or 14 genes) in which expression of the genes would benefit from treatment comprising a high level of immune binding to the individual, wherein the increased expression of the PD-L1 axis binding antagonist comprises a reference level of the PD, wherein the subject's would benefit from treatment comprising a high level of the increased expression of the PD-1 or a high level of the PD-1.
In yet another example, provided herein is a method of selecting a therapy for an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising determining the expression levels of two or more (e.g., 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, or 14) of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 in a sample from the individual, wherein in the event that the level of immune score expression of the two or more genes is greater than the reference level of immune score expression of the two or more genes, identifying the individual as an individual likely to benefit from treatment comprising a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attritumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)), wherein the benefit comprises a prolongation of OS in the individual as compared to treatment without the PD-L1 axis binding antagonist.
In some cases, the immune score expression level of the two or more genes in the sample is higher than the reference immune score expression level, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)). Any suitable PD-L1 axis binding antagonist can be administered, e.g., any PD-L1 axis binding antagonist provided herein (e.g., as described in section IV below).
Any combination of plasma B cell signature genes can be determined. For example, the combination may include two genes selected from MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5, e.g., any one of the combinations listed in Table 10. In another example, the combination may include three genes selected from MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5, e.g., any one of the combinations listed in Table 11. In another example, the combination may include four genes selected from MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5, e.g., any one of the combinations listed in table 12. In another example, the combination can include five genes selected from MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5, e.g., any one of the combinations listed in table 13. In another example, the combination may include six genes selected from MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5, e.g., any one of the combinations listed in table 14. In another example, the combination may include seven genes selected from MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5, e.g., any one of the combinations listed in Table 15.
Table 10: exemplary two-Gene combinations of plasma B cell signature genes
Figure BDA0003990674580001021
Figure BDA0003990674580001031
Table 11: exemplary three-Gene combinations of plasma B cell signature genes
MZB1, DERL3 and JSRP1
MZB1, DERL3 and TNFRSF17
MZB1, DERL3 and SLAMF7
MZB1, DERL3 and IGHG2
MZB1, DERL3 and IGHGP
MZB1, DERL3 and IGLV3-1
MZB1, DERL3 and IGLV6-57
MZB1, DERL3 and IGHA2
MZB1, DERL3 and IGKV4-1
MZB1, DERL3 and IGKV1-12
MZB1, DERL3 and IGLC7
MZB1, DERL3 and IGLL5
MZB1, JSRP1 and TNFRSF17
MZB1, JSRP1 and SLAMF7
MZB1, JSRP1 and IGHG2
MZB1, JSRP1 andIGHGP
MZB1, JSRP1 and IGLV3-1
MZB1, JSRP1 and IGLV6-57
MZB1, JSRP1 and IGHA2
MZB1, JSRP1 and IGKV4-1
MZB1, JSRP1 and IGKV1-12
MZB1, JSRP1 and IGLC7
MZB1, JSRP1 and IGLL5
MZB1, TNFRSF17 and SLAMF7
MZB1, TNFRSF17 and IGHG2
MZB1, TNFRSF17 and IGHGP
MZB1, TNFRSF17 and IGLV3-1
MZB1, TNFRSF17 and IGLV6-57
MZB1, TNFRSF17 and IGHA2
MZB1, TNFRSF17 and IGKV4-1
MZB1, TNFRSF17 and IGKV1-12
MZB1, TNFRSF17 and IGLC7
MZB1, TNFRSF17 and IGLL5
Table 12: exemplary four Gene combinations of plasma B cell signature genes
Figure BDA0003990674580001051
Figure BDA0003990674580001061
Table 13: exemplary five-Gene combinations of plasma B cell signature genes
MZB1, DERL3, JSRP1, TNFRSF17, and SLAMF7
MZB1, DERL3, JSRP1, TNFRSF17, and IGHG2
MZB1, DERL3, JSRP1, TNFRSF17, and IGHGP
MZB1, DERL3, JSRP1, TNFRSF17, and IGLV3-1
MZB1, DERL3, JSRP1, TNFRSF17, and IGLV6-57
MZB1, DERL3, JSRP1, TNFRSF17, and IGHA2
MZB1, DERL3, JSRP1, TNFRSF17, and IGKV4-1
MZB1, DERL3, JSRP1, TNFRSF17, and IGKV1-12
MZB1、DERL3、JSRP1, TNFRSF17 and IGLC7
MZB1, DERL3, JSRP1, TNFRSF17, and IGLL5
MZB1, DERL3, JSRP1, SLAMF7, and IGHG2
MZB1, DERL3, JSRP1, SLAMF7, and IGHGP
MZB1, DERL3, JSRP1, SLAMF7, and IGLV3-1
MZB1, DERL3, JSRP1, SLAMF7 and IGLV6-57
MZB1, DERL3, JSRP1, SLAMF7 and IGHA2
MZB1, DERL3, JSRP1, SLAMF7, and IGKV4-1
MZB1, DERL3, JSRP1, SLAMF7, and IGKV1-12
MZB1, DERL3, JSRP1, SLAMF7, and IGLC7
MZB1, DERL3, JSRP1, SLAMF7, and IGLL5
MZB1, DERL3, JSRP1, IGHG2 and IGHGP
MZB1, DERL3, JSRP1, IGHG2, and IGLV3-1
MZB1, DERL3, JSRP1, IGHG2, and IGLV6-57
MZB1, DERL3, JSRP1, IGHG2, and IGHA2
MZB1, DERL3, JSRP1, IGHG2 and IGKV4-1
MZB1, DERL3, JSRP1, IGHG2, and IGKV1-12
MZB1, DERL3, JSRP1, IGHG2, and IGLC7
MZB1, DERL3, JSRP1, IGHG2, and IGLL5
Table 14: exemplary six-Gene combinations of plasma B cell signature genes
Figure BDA0003990674580001062
Figure BDA0003990674580001071
Table 15: exemplary seven Gene combinations of plasma B cell signature genes
Figure BDA0003990674580001072
Figure BDA0003990674580001081
In some cases, the genes include MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5.
In some cases, the expression level is a nucleic acid expression level. For example, in some cases, the nucleic acid expression level is an mRNA expression level. mRNA expression levels can be determined using any suitable method (e.g., any method disclosed herein). In some cases, mRNA expression levels are determined by RNA-seq, RT-qPCR, multiplex qPCR or RT-qPCR, microarray analysis, SAGE, massARRAY technology, FISH, or combinations thereof. In some cases, mRNA expression levels are detected using RNA-seq.
In other cases, the expression level is a protein expression level. Protein expression levels can be determined using any suitable method (e.g., any of the methods disclosed herein). In some cases, protein expression levels are determined by IHC, immunofluorescence, mass spectrometry, flow cytometry, and western blotting, or combinations thereof.
Any suitable sample may be used. In some cases, the sample is a tissue sample, a cell sample, a whole blood sample, a plasma sample, a serum sample, or a combination thereof. In some cases, the tissue sample is a tumor tissue sample. In some cases, the tumor sample is a tumor tissue sample. In some cases, the tumor tissue sample comprises tumor cells, tumor infiltrating immune cells, stromal cells, NAT cells, or a combination thereof. In some cases, the tumor tissue sample is an FFPE sample, an archived sample, a fresh sample, or a frozen sample. In some cases, the tumor tissue sample is an FFPE sample.
The cancer may be any suitable type of cancer. In some cases, the cancer is lung cancer, kidney cancer, bladder cancer, breast cancer, colorectal cancer, ovarian cancer, pancreatic cancer, stomach cancer, esophageal cancer, mesothelioma, melanoma, head and neck cancer, thyroid cancer, sarcoma, prostate cancer, glioblastoma, cervical cancer, thymus cancer, leukemia, lymphoma, myeloma, mycosis fungoides, merkel cell carcinoma, or a hematological malignancy. In some cases, the cancer is lung, kidney, bladder, or breast cancer. In some cases, the lung cancer is NSCLC. In some cases, the NSCLC is non-squamous NSCLC. In some cases, the NSCLC is squamous NSCLC.
In some cases, the benefit comprises a prolongation of OS in the individual, a prolongation of PFS in the individual, and/or an improvement in BCOR in the individual as compared to treatment without the PD-L1 axis binding antagonist. In some cases, the benefit comprises an extension of Overall Survival (OS) of the individual as compared to treatment without the PD-L1 axis binding antagonist.
B. Tertiary Lymphatic Structure (TLS)
In some aspects, the methods provided herein can involve determining the presence of TLS in a sample (e.g., a tumor sample) from an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), renal cancer (e.g., RCC), and breast cancer (e.g., TNBC)).
For example, provided herein is a method of identifying an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) that is likely to benefit from treatment with a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)), comprising determining the presence of a Tertiary Lymphoid Structure (TLS) in a sample (e.g., a tumor sample) from the individual, wherein the presence of the TLS in the sample identifies the individual as an individual that is likely to benefit from treatment with the PD-L1 axis binding antagonist.
In another example, provided herein is a method of selecting a therapy for an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising determining the presence of TLS in a sample (e.g., a tumor sample) from the individual, wherein the presence of TLS in the sample identifies the individual as an individual who is likely to benefit from treatment with a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., attritumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In some cases, the presence of TLS is determined in a sample from the individual, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attritumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)). Any suitable PD-L1 axis binding antagonist can be administered, e.g., any PD-L1 axis binding antagonist provided herein (e.g., as described in section IV below).
Any suitable method can be used to determine the presence of TLS in a sample. For example, in some cases, the presence of TLS is determined by histological staining, IHC, immunofluorescence, or gene expression analysis.
Any suitable histological staining method may be used. For example, in some cases, histological staining includes hematoxylin and eosin (H & E) staining.
Any suitable IHC or immunofluorescence method may be used. In some cases, IHC or immunofluorescence includes detecting CD62L, L-selectin, CD40, or CD8, e.g., using antibodies (e.g., anti-CD 62L antibodies, anti-L-selectin antibodies, anti-CD 40 antibodies, and/or anti-CD 8 antibodies). In some cases, the MECA-79 antibody is used to detect CD62L or L-selectin.
In some cases, the gene expression analysis comprises determining the expression level of a TLS gene signature in the sample. For example, gene expression analysis can involve determining the expression level of any of the TLS features disclosed herein (see, e.g., section II, section C, below). In some cases, a TLS gene signature comprises one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12) of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13. In some cases, the gene comprises two or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13.
In some cases, the sample may include one TLS. In other cases, a sample can include more than one TLS, e.g., 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 50, 60, 70, 80, 90, 100, or more TLSs.
Any suitable sample may be used. In some cases, the sample is a tissue sample, a cell sample, a whole blood sample, a plasma sample, a serum sample, or a combination thereof. In some cases, the tissue sample is a tumor tissue sample. In some cases, the tumor sample is a tumor tissue sample. In some cases, the tumor tissue sample comprises tumor cells, tumor infiltrating immune cells, stromal cells, NAT cells, or a combination thereof. In some cases, the tumor tissue sample is an FFPE sample, an archived sample, a fresh sample, or a frozen sample. In some cases, the tumor tissue sample is an FFPE sample.
The cancer may be any suitable type of cancer. In some cases, the cancer is lung cancer, kidney cancer, bladder cancer, breast cancer, colorectal cancer, ovarian cancer, pancreatic cancer, stomach cancer, esophageal cancer, mesothelioma, melanoma, head and neck cancer, thyroid cancer, sarcoma, prostate cancer, glioblastoma, cervical cancer, thymus cancer, leukemia, lymphoma, myeloma, mycosis fungoides, merkel cell carcinoma, or a hematological malignancy. In some cases, the cancer is lung, kidney, bladder, or breast cancer. In some cases, the lung cancer is NSCLC. In some cases, the NSCLC is non-squamous NSCLC. In some cases, the NSCLC is squamous NSCLC.
In some cases, the benefit comprises a prolongation of OS in the individual, a prolongation of PFS in the individual, and/or an improvement in BCOR in the individual as compared to treatment without the PD-L1 axis binding antagonist. In some cases, the benefit includes an extension of the Overall Survival (OS) of the individual as compared to treatment without the PD-L1 axis binding antagonist.
C.TLS feature
In some aspects, the methods provided herein can involve determining the expression level of one or more genes in the TLS signature. Any suitable TLS feature may be used. For example, the TLS signature can include one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12) genes listed in table 16.
Table 16: exemplary TLS signature genes
CCL2
CCL3
CCL4
CCL5
CCL8
CCL18
CCL19
CCL21
CXCL9
CXCL10
CXCL11
CXCL13
For example, provided herein is a method of identifying an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) who may benefit from treatment comprising a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attrituzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)), the method comprising determining, in a sample from the individual, an expression level of one or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12), wherein an individual who may benefit from an immune expression level of the one or more genes is higher than an immune expression level of the reference axis binding antagonist, the individual would benefit from treatment comprising the PD-L1.
In another example, provided herein is a method of selecting a therapy for an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising determining an expression level of one or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12) in a sample from the individual, wherein the individual is identified as likely to comprise a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 binding antagonist, e.g., an anti-PD-1 bead antibody, e.g., an anti-PD 1-1 monoclonal antibody)) for the treatment of the individual.
In some cases, the immune score expression level of one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12) genes in the sample is greater than a reference immune score expression level of the one or more genes, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as alemtuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)). Any suitable PD-L1 axis binding antagonist can be administered, e.g., any PD-L1 axis binding antagonist provided herein (e.g., as described in section IV below).
Any suitable immuno-score reference expression level can be used. In some cases, the immune score reference expression level is an immune score expression level of one or more genes in the reference population. In some cases, the reference population is a population of individuals with cancer. In some cases, the population of individuals includes a first subset of individuals who have received treatment with a PD-L1 axis binding antagonist and a second subset of individuals who have received treatment with a therapy that does not contain a PD-L1 axis binding antagonist. In some cases, the reference immune score expression level visibly differentiates each of the first subset of individuals from the second subset of individuals based on a significant difference between the individual's responsiveness to treatment with a PD-L1 axis binding antagonist and the individual's responsiveness to treatment with a therapy that does not contain a PD-L1 axis binding antagonist, above the reference immune score expression level, wherein the individual's responsiveness to treatment with a PD-L1 axis binding antagonist is significantly improved relative to the individual's responsiveness to treatment with a therapy that does not contain a PD-L1 axis binding antagonist. In some cases, the therapy without the PD-L1 axis binding antagonist comprises an anti-tumor agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, or a combination thereof. In some cases, the therapy without the PD-L1 axis binding antagonist comprises a chemotherapeutic agent. In some cases, the chemotherapeutic agent is docetaxel. In some cases, responsiveness to treatment comprises prolongation of OS, prolongation of PFS, or an increase in BCOR. In some cases, responsiveness to treatment includes an extension of Overall Survival (OS). In some cases, the reference immune score expression level is the median of the expression levels of each of the one or more genes in the reference population. In some cases, the median expression level is the median of the mean Z scores for the expression levels of each of the one or more genes in the reference population.
In some cases, the gene comprises two or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13.
For example, provided herein is a method of identifying an individual having a cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) who is likely to benefit from treatment comprising a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as astuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)), comprising determining the expression levels of two or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 (e.g., 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12) in a sample from the individual, wherein identifying the individual as having a PD-L1 axis binding antagonist is likely to benefit from treatment wherein the individual comprises identifying the reference expression level of the PD-L1 axis binding antagonist.
In another example, provided herein is a method of selecting a therapy for an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising determining an expression level of two or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 (e.g., 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12) in a sample from the individual, wherein the individual is identified as likely to benefit from treatment of the individual comprising a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., attritrin bead antagonist) or an anti-PD 1 binding antibody, e.g., anti-PD 1 binding monoclonal antibody)).
In some cases, the immune score expression level of two or more genes in the sample is greater than the reference immune score expression level, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist. Any suitable PD-L1 axis binding antagonist can be administered, e.g., any PD-L1 axis binding antagonist provided herein (e.g., as described in section IV below).
In some cases, the reference immune score expression level is an immune score expression level of two or more genes in a reference population. In some cases, the reference population is a population of individuals with cancer. In some cases, the population of individuals includes a first subset of individuals who have received treatment with a PD-L1 axis binding antagonist and a second subset of individuals who have received treatment with a therapy that does not contain a PD-L1 axis binding antagonist. In some cases, the reference immune score expression level visibly differentiates each of the first subset of individuals from the second subset of individuals based on a significant difference between the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist and the responsiveness of the individual to treatment with the therapy without the PD-L1 axis binding antagonist above the reference expression level, wherein the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist is significantly improved relative to the responsiveness of the individual to treatment with the therapy without the PD-L1 axis binding antagonist. In some cases, the therapy without the PD-L1 axis binding antagonist comprises an anti-neoplastic agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, or a combination thereof. In some cases, the therapy without the PD-L1 axis binding antagonist comprises a chemotherapeutic agent. In some cases, the chemotherapeutic agent is docetaxel. In some cases, responsiveness to treatment comprises prolongation of OS, prolongation of PFS, or an increase in BCOR. In some cases, responsiveness to treatment includes an extension of Overall Survival (OS). In some cases, the reference immune score expression level is the median of the expression levels of each of the two or more genes in the reference population. In some cases, the median expression level is the median of the mean Z scores for the expression levels of each of the two or more genes in the reference population.
In some cases, the gene comprises three or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13. In some cases, the gene comprises four or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13. In some cases, the gene comprises five or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13. In some cases, the gene comprises six or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13. In some cases, the gene comprises seven or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13. In some cases, the gene comprises eight or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13. In some cases, the gene comprises nine or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13. In some cases, the gene comprises ten or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13. In some cases, the gene comprises eleven or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13.
Any combination of TLS signature genes can be determined, for example, as any combination of two genes selected from: CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13; any combination of three genes selected from: CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13; any combination of four genes selected from: CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13; any combination of five genes selected from: CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13; any combination of six genes selected from: CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13; any combination of seven genes selected from: CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13; any combination of eight genes selected from: CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13; any combination of nine genes selected from: CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13; any combination of ten genes selected from: CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13; any combination of eleven genes selected from: CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13; or any combination of eleven genes selected from: CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11 and CXCL13.
In some cases, the gene comprises CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13.
In some cases, the expression level is a nucleic acid expression level. For example, in some cases, the nucleic acid expression level is an mRNA expression level. mRNA expression levels can be determined using any suitable method (e.g., any method disclosed herein). In some cases, mRNA expression levels are determined by RNA-seq, RT-qPCR, multiplex qPCR or RT-qPCR, microarray analysis, SAGE, massARRAY technology, FISH, or combinations thereof. In some cases, mRNA expression levels are detected using RNA-seq.
In other cases, the expression level is a protein expression level. Protein expression levels can be determined using any suitable method (e.g., any of the methods disclosed herein). In some cases, protein expression levels are determined by IHC, immunofluorescence, mass spectrometry, flow cytometry, and western blot, or a combination thereof.
Any suitable sample may be used. In some cases, the sample is a tissue sample, a cell sample, a whole blood sample, a plasma sample, a serum sample, or a combination thereof. In some cases, the tissue sample is a tumor tissue sample. In some cases, the tumor sample is a tumor tissue sample. In some cases, the tumor tissue sample comprises tumor cells, tumor infiltrating immune cells, stromal cells, NAT cells, or a combination thereof. In some cases, the tumor tissue sample is an FFPE sample, an archived sample, a fresh sample, or a frozen sample. In some cases, the tumor tissue sample is an FFPE sample.
The cancer may be any suitable type of cancer. In some cases, the cancer is lung cancer, kidney cancer, bladder cancer, breast cancer, colorectal cancer, ovarian cancer, pancreatic cancer, stomach cancer, esophageal cancer, mesothelioma, melanoma, head and neck cancer, thyroid cancer, sarcoma, prostate cancer, glioblastoma, cervical cancer, thymus cancer, leukemia, lymphoma, myeloma, mycosis fungoides, merkel cell carcinoma, or a hematological malignancy. In some cases, the cancer is lung, kidney, bladder, or breast cancer. In some cases, the lung cancer is NSCLC. In some cases, the NSCLC is non-squamous NSCLC. In some cases, the NSCLC is squamous NSCLC.
In some cases, the benefit comprises a prolongation of OS in the individual, a prolongation of PFS in the individual, and/or an improvement in BCOR in the individual as compared to treatment without the PD-L1 axis binding antagonist. In some cases, the benefit includes an extension of the Overall Survival (OS) of the individual as compared to treatment without the PD-L1 axis binding antagonist.
B cell number and clonally expanded B cells
In some aspects, the methods provided herein can involve determining the presence and/or number of B cells in a sample from an individual. In some aspects, the methods provided herein can involve determining the presence and/or number of clonally expanded B cells in a sample from an individual.
For example, provided herein is a method of identifying an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) that is likely to benefit from treatment with a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)), comprising determining the number of B cells in a sample (e.g., a tumor sample) from the individual, wherein the individual is identified as an individual that is likely to benefit from treatment with the PD-L1 axis binding antagonist if the number of B cells in the sample is greater than a reference number of B cells.
In another example, provided herein is a method of selecting a therapy for an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising determining the number of B cells in a sample (e.g., a tumor sample) from the individual, wherein the individual is identified as an individual who is likely to benefit from treatment with a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., altemazumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) where the number of B cells in the tumor sample is greater than a reference number of B cells.
In some cases, the number of B cells in the sample is greater than the reference number, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)). Any suitable PD-L1 axis binding antagonist can be administered, e.g., any PD-L1 axis binding antagonist provided herein (e.g., as described in section IV below).
The presence and/or quantity of any suitable type of B cell can be determined. For example, in some cases, B cells include CD79+ B cells, igG + B cells, and/or plasma cells.
In some embodiments, the presence and/or number of clonally expanded B cells may be determined.
For example, provided herein is a method of identifying an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) who may benefit from treatment comprising a PD-L1 axis binding antagonist (e.g., an anti-PD-L1 antibody, such as attentimab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)), the method comprising determining whether the individual has clonally expanded B cells in a sample (e.g., a tumor sample) from the individual, wherein the clonally expanded B cells in the sample identify the individual as an individual who may benefit from treatment comprising a PD-L1 axis binding antagonist.
In another example, provided herein is a method of selecting a therapy for an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising determining whether the individual has clonally expanded B cells in a sample (e.g., a tumor sample) from the individual, wherein the clonally expanded B cells in the sample identify the individual as an individual likely to benefit from treatment with a PD-L1 axis binding antagonist (e.g., an anti-PD-L1 antibody, e.g., attrituximab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In some cases, the sample (e.g., a tumor sample) comprises clonally expanded B cells, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., an anti-PD-L1 antibody, e.g., attritumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
The clonally expanded B cells may be any type of B cells. For example, in some cases, the clonally expanded B cells are clonally expanded plasma cells.
Clonally expanded B cells may be detected by any suitable method. For example, in some cases, clonally expanded B cells are detected by measuring the diversity of B Cell Receptor (BCR) gene lineages in tumor samples. In some cases, where a Shannon Diversity Index (SDI) of a BCR gene lineage in a tumor sample from an individual is lower than a reference SDI, the individual is identified as an individual who is likely to benefit from treatment comprising a PD-L1 axis binding antagonist.
Any suitable sample may be used. In some cases, the sample is a tissue sample, a cell sample, a whole blood sample, a plasma sample, a serum sample, or a combination thereof. In some cases, the tissue sample is a tumor tissue sample. In some cases, the tumor sample is a tumor tissue sample. In some cases, the tumor tissue sample comprises tumor cells, tumor infiltrating immune cells, stromal cells, NAT cells, or a combination thereof. In some cases, the tumor tissue sample is an FFPE sample, an archived sample, a fresh sample, or a frozen sample. In some cases, the tumor tissue sample is an FFPE sample.
The cancer may be any suitable type of cancer. In some cases, the cancer is lung cancer, kidney cancer, bladder cancer, breast cancer, colorectal cancer, ovarian cancer, pancreatic cancer, stomach cancer, esophageal cancer, mesothelioma, melanoma, head and neck cancer, thyroid cancer, sarcoma, prostate cancer, glioblastoma, cervical cancer, thymus cancer, leukemia, lymphoma, myeloma, mycosis fungoides, merkel cell carcinoma, or a hematological malignancy. In some cases, the cancer is lung, kidney, bladder, or breast cancer. In some cases, the lung cancer is NSCLC. In some cases, the NSCLC is non-squamous NSCLC. In some cases, the NSCLC is squamous NSCLC.
In some cases, the benefit comprises a prolongation of OS in the individual, a prolongation of PFS in the individual, and/or an improvement in BCOR in the individual as compared to treatment without the PD-L1 axis binding antagonist. In some cases, the benefit comprises an extension of Overall Survival (OS) of the individual as compared to treatment without the PD-L1 axis binding antagonist.
E.T Effector characteristics
Any of the methods described herein may further comprise determining the presence and/or expression level of one or more T effector characteristic genes. Any suitable T effector feature may be used. For example, the T effector characteristic may include one or more (e.g., 1, 2, 3, 4, 5, 6, 7, or 8) genes listed in table 17. In some cases, CD274 is further detected.
Table 17: exemplary T Effector signature genes
CD8A
EOMES
GZMA
TBX21
IFNG
GZMB
CXCL9
CXCL10
For example, provided herein is a method of identifying an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) that may benefit from treatment with a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., attrituzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)), the method comprising determining, in a sample from the individual, one or more of (i) the genes listed in table 1 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, or 20) and (ii) the genes CD8A, EOMES, GZMA, TBX21, ifcl, cxb, CXCL and 10 (e.g., TNBC), 1, 2, 3, 4, 5, 6, 7, or 8), wherein the individual is identified as an individual likely to benefit from treatment with the PD-L1 axis binding antagonist in the event that the immune score expression level of (i) one or more of the genes listed in table 1 and (ii) one or more of the genes CD8A, EOMES, GZMA, TBX21, IFNG, GZMB, CXCL9, and CXCL10 is greater than the reference immune score expression level of one or more of the genes listed in table 1 and one or more of the genes CD8A, EOMES, GZMA, TBX21, IFNG, GZMB, CXCL9, and CXCL 10.
In another example, provided herein is a method of selecting a therapy for an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising determining in a sample from the individual (i) one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, or 20) of the genes listed in table 1 and (ii) one or more (e.g., 1, 2, 3, 4, 5, 6, 7, or 8), wherein the individual is identified as an individual who is likely to benefit from treatment with a PD-L1 axis binding antagonist (e.g., an anti-PD-L1 antibody, such as attritor mab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) if the immune score expression level of (i) one or more of the genes listed in table 1 and (ii) one or more of the genes CD8A, EOMES, GZMA, TBX21, ifcl 9, and CXCL10 is higher than the reference immune score expression level of one or more of the genes listed in table 1 and one or more of the genes CD8A, EOMES, GZMA, TBX21, IFNG, GZMB, CXCL9, and CXCL 10.
In some cases, the immune score expression level of one or more of (i) the genes listed in table 1 and (ii) one or more of the genes CD8A, EOMES, GZMA, TBX21, IFNG, GZMB, CXCL9, and CXCL10 in the sample is greater than the reference immune score expression level, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist. Any suitable PD-L1 axis binding antagonist can be administered, e.g., any PD-L1 axis binding antagonist provided herein (e.g., as described in section IV below).
In some cases, the reference immune score expression level is an immune score expression level of one or more of (i) one or more genes listed in table 1 and (ii) one or more of the genes CD8A, EOMES, GZMA, TBX21, IFNG, GZMB, CXCL9, and CXCL10 in the reference population. In some cases, the reference population is a population of individuals with cancer. In some cases, the population of individuals includes a first subset of individuals who have received treatment with a PD-L1 axis binding antagonist and a second subset of individuals who have received treatment with a therapy that does not contain a PD-L1 axis binding antagonist. In some cases, the reference immune score expression level clearly distinguishes each of the first subset of individuals from the second subset of individuals based on a significant difference between the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist and the responsiveness of the individual to treatment with the therapy that does not contain the PD-L1 axis binding antagonist above the reference expression level, where the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist is significantly improved relative to the responsiveness of the individual to treatment with the therapy that does not contain the PD-L1 axis binding antagonist. In some cases, the therapy without the PD-L1 axis binding antagonist comprises an anti-neoplastic agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, or a combination thereof. In some cases, the therapy without the PD-L1 axis binding antagonist comprises a chemotherapeutic agent. In some cases, the chemotherapeutic agent is docetaxel. In some cases, responsiveness to treatment comprises prolongation of OS, prolongation of PFS, or an increase in BCOR. In some cases, responsiveness to treatment includes an extension of Overall Survival (OS). In some cases, the reference immune score expression level is the median of the expression levels of each of the two or more genes in the reference population. In some cases, the median expression level is the median of the mean Z scores for the expression levels of each of (i) the one or more genes listed in table 1 and (ii) the genes CD8A, EOMES, GZMA, TBX21, IFNG, GZMB, CXCL9, and CXCL10 in the reference population.
In another example, provided herein is a method of identifying an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., NSCLC), kidney cancer (e.g., rcuc), and breast cancer (e.g., TNBC)) that may benefit from treatment with a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)), the method comprising determining in a sample from the individual (i) one or more of B-cell signature genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) and (ii) the expression level of one or more (e.g., 1, 2, 3, 4, 5, 6, 7, or 8) of the T effector feature genes CD8A, EOMES, GZMA, TBX21, IFNG, GZMB, CXCL9, and CXCL10, wherein the individual is identified as an individual likely to benefit from treatment with the PD-L1 axis binding antagonist if (i) the one or more B cell feature genes and (ii) the one or more T effector feature genes are greater than the reference immune score expression level of the one or more B cell feature genes and the one or more T effector feature genes.
In yet another example, provided herein is a method of selecting a therapy for an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising determining in a sample from the individual one or more of (i) B cell signature genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) and (ii) T effector signature genes CD8A, EOMES, GZMA, TBX21, IFNG, gzm B, CXCL9, and CXCL10 (e.g., 1, 2, 3, 4, 5, 6, 7, or 8 antagonists) wherein the expression of the one or more of the B cell signature genes (e.g., PD) is likely to be expressed at a level that is higher than the level of the anti-PD 1-effector gene, e.g., when the anti-PD gene is expressed by the individual, and the anti-PD receptor(s) and the anti-PD) signature genes are expressed at a level that is high, e.g., when the anti-PD 1-PD gene is likely to the anti-PD gene.
In some cases, the immune score expression level of (i) the one or more B cell signature genes and (ii) the one or more T effector signature genes in the sample is greater than a reference immune score expression level, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist. Any suitable PD-L1 axis binding antagonist can be administered, e.g., any PD-L1 axis binding antagonist provided herein (e.g., as described in section IV below).
In some cases, the reference immune score expression level is an immune score expression level of (i) the one or more B cell signature genes and (ii) the one or more T effector signature genes in the reference population. In some cases, the reference population is a population of individuals with cancer. In some cases, the population of individuals includes a first subset of individuals who have received treatment with a PD-L1 axis binding antagonist and a second subset of individuals who have received treatment with a therapy that does not contain a PD-L1 axis binding antagonist. In some cases, the reference immune score expression level clearly distinguishes each of the first subset of individuals from the second subset of individuals based on a significant difference between the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist and the responsiveness of the individual to treatment with the therapy that does not contain the PD-L1 axis binding antagonist above the reference expression level, where the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist is significantly improved relative to the responsiveness of the individual to treatment with the therapy that does not contain the PD-L1 axis binding antagonist. In some cases, the therapy without the PD-L1 axis binding antagonist comprises an anti-neoplastic agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, or a combination thereof. In some cases, the therapy without the PD-L1 axis binding antagonist comprises a chemotherapeutic agent. In some cases, the chemotherapeutic agent is docetaxel. In some cases, responsiveness to treatment comprises a prolongation of OS, a prolongation of PFS, or an increase in BCOR. In some cases, responsiveness to treatment includes an extension of Overall Survival (OS). In some cases, the reference immune score expression level is the median of the expression levels of each of the two or more genes in the reference population. In some cases, the median expression level is the median of the mean Z-scores of the expression levels of each of (i) the one or more B cell signature genes and (ii) the one or more T effector signature genes in the reference population.
In another example, provided herein is a method of identifying an individual having a cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) who is likely to benefit from treatment comprising a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as alemtuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)), comprising determining in a sample from the individual the level of (i) one or more of the TLS signature genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, cl9, CXCL10, CXCL11, and CXCL13 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12) and (ii) the T effector signature gene antagonist (e.g., CD8A, eoa, mes, 10, 11, or 12) and (ii) in which the individual is likely to benefit from a treatment comprising one or more of PD-L1 axis binding of the PD-L1, 2, gmc, or TNBC) and a high level of the signature gene.
In yet another example, provided herein is a method of selecting a therapy for an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising determining in a sample from the individual one or more of (i) the TLS signature genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12) and (ii) the T effector signature genes CD8A, EOMES, GZMA, TBX21, IFNG, GZMB, CXCL9, and CXCL10 (e.g., 1, 2, 3, 4, 5, 6, 7, or 12) and (ii) wherein the level of one or more of the anti-TLS signature genes (e.g., binding to the anti-PD antagonist) is expressed at a level that would benefit from treatment with the anti-PD 1 or more of the anti-PD 1-PD antagonist, e.g., PD, e.g., anti-PD, and anti-PD 1, e.g., anti-PD, and a monoclonal antibody.
In some cases, the immune score expression level of (i) the one or more TLS signature genes and (ii) the one or more T effector signature genes in the sample is greater than a reference immune score expression level, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist. Any suitable PD-L1 axis binding antagonist can be administered, e.g., any PD-L1 axis binding antagonist provided herein (e.g., as described in section IV below).
In some cases, the reference immune score expression level is the immune score expression level of (i) the one or more TLS signature genes and (ii) the one or more T effector signature genes in the reference population. In some cases, the reference population is a population of individuals with cancer. In some cases, the population of individuals includes a first subset of individuals who have received treatment with a PD-L1 axis binding antagonist and a second subset of individuals who have received treatment with a therapy that does not contain a PD-L1 axis binding antagonist. In some cases, the reference immune score expression level clearly distinguishes each of the first subset of individuals from the second subset of individuals based on a significant difference between the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist and the responsiveness of the individual to treatment with the therapy that does not contain the PD-L1 axis binding antagonist above the reference expression level, where the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist is significantly improved relative to the responsiveness of the individual to treatment with the therapy that does not contain the PD-L1 axis binding antagonist. In some cases, the therapy without the PD-L1 axis binding antagonist comprises an anti-neoplastic agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, or a combination thereof. In some cases, the therapy without the PD-L1 axis binding antagonist comprises a chemotherapeutic agent. In some cases, the chemotherapeutic agent is docetaxel. In some cases, responsiveness to treatment comprises prolongation of OS, prolongation of PFS, or an increase in BCOR. In some cases, responsiveness to treatment includes an extension of Overall Survival (OS). In some cases, the reference immune score expression level is the median of the expression levels of each of the two or more genes in the reference population. In some cases, the median expression level is the median of the mean Z scores for the expression levels of each of (i) the one or more TLS signature genes and (ii) the one or more T effector signature genes in the reference population.
In some examples of any of the foregoing methods, the presence and/or level of expression of CD274 is further determined.
In any of the methods described herein, the method can further comprise determining the expression level of CD79A, CD274, and the expression level of one or more (e.g., 1, 2, 3, 4, 5, 6, 7, or 8) of the T effector feature genes CD8A, EOMES, GZMA, TBX21, IFNG, GZMB, CXCL9, and CXCL 10.
F. Determination of expression levels
(i) Detection method
The level of immune score expression of a gene described herein (e.g., one or more genes listed in any of tables 1-17) can be based on the level of nucleic acid expression, and preferably on the level of mRNA expression. The presence and/or expression level/amount of a gene described herein can be determined qualitatively and/or quantitatively based on any suitable standard known in the art, including but not limited to DNA, mRNA, cDNA, protein fragment, and/or gene copy number.
In some cases, the nucleic acid expression level of a gene described herein (e.g., one or more genes listed in any one of tables 1-17) can be measured by Polymerase Chain Reaction (PCR) -based assays (e.g., quantitative PCR, real-time PCR, quantitative real-time PCR (qRT-PCR), reverse transcriptase PCR (RT-PCR), and reverse transcriptase quantitative PCR (RT-qPCR)). Platforms for performing quantitative PCR assays include (e.g., BIOMARK) TM HD system). Other amplification-based methods include, for example, transcription-mediated amplification (TMA), strand Displacement Amplification (SDA), nucleic acid sequence-based amplification (NASBA), and signal amplification methods such as bDNA.
In some cases, the nucleic acid expression levels of the genes described herein (e.g., one or more of the genes listed in any of tables 1-17) can also be determined by sequencing-based techniques such as RNA-seq, serial Analysis of Gene Expression (SAGE), high-throughput sequencing techniques (e.g., massively parallel sequencing), and Sequenom
Figure BDA0003990674580001261
The technique takes a measurement. Nucleic acid expression levels (e.g., expression levels of one or more of the genes listed in any of tables 1-17) can also be measured by, for example, nanoString nCounter and high coverage expression profiling (HiCEP). Other Protocols for assessing the status of genes and gene products can be found, for example, in Ausubel et al, 1995, current Protocols In Molecular Biology, unit 2 (Northern blot), 4 (Southern blot), 15 (immunoblot) and 18 (PCR analysis).
Other methods for detecting the nucleic acid square of a gene described herein (e.g., one or more genes listed in any of tables 1-17) include protocols for examining or detecting mRNA (such as a target mRNA) in a tissue or cell sample by microarray technology. Test and control mRNA samples from the test and control tissue samples were reverse transcribed and labeled using a nucleic acid microarray to generate cDNA probes. The probes are then hybridized to an array of nucleic acids immobilized on a solid support. The array is configured so that the order and location of each component of the array is known. Hybridization of a labeled probe to a particular array element indicates that the sample from which the probe was derived expresses the gene.
The primers and probes may be labeled with a detectable marker, such as a radioisotope, a fluorescent compound, a bioluminescent compound, a chemiluminescent compound, a metal chelator or an enzyme. Such probes and primers may be used to detect the presence of a gene expressed in a sample, such as one or more of the genes listed in any one of tables 1 to 17. As will be understood by those skilled in the art, many different primers and probes can be prepared based on the sequences provided herein (or their adjacent sequences in the case of genomic DNA) and used effectively to amplify, clone and/or determine the presence of and/or the expression level of the genes described herein.
Other methods for detecting the level of nucleic acid expression of a gene described herein (e.g., one or more genes listed in any one of tables 1 to 17) include electrophoresis, northern blot and Southern blot analysis, in situ hybridization (e.g., single or multiplex nucleic acid in situ hybridization), rnase protection assays, and microarrays (e.g., illumina BEADARRAY) TM Technology); bead Arrays (BADGE)) for detecting gene expression.
In some cases, the level of immune score expression of a gene described herein (e.g., one or more genes listed in any one of tables 1-17) can be analyzed by a variety of methods, including but not limited to RNA-seq, PCR, RT-qPCR, multiplex RT-qPCR,
Figure BDA0003990674580001271
Gene expression determination, microarray analysis, serial Analysis of Gene Expression (SAGE), northern blottingAnalysis, massARRAY, ISH, and whole genome sequencing, or a combination thereof.
In further instances, the level of immune score expression of a gene described herein (e.g., one or more genes listed in any one of tables 1-17) in a sample can be detected using a method selected from the group consisting of: RNA-seq, RT-qPCR, multiplex RT-qPCR, microarray analysis, SAGE, massARRAY technology, FACS, western blot analysis, ELISA, immunoprecipitation, immunohistochemistry, immunofluorescence, radioimmunoassay, dot hybridization, immunodetection methods, HPLC, surface plasmon resonance, spectroscopy, mass spectrometry, HPLC, and ISH, or combinations thereof.
(ii)RT-qPCR
In some cases, the level of nucleic acid expression of a gene described herein (e.g., one or more genes listed in any one of tables 1 to 17) can be detected using reverse transcription quantitative polymerase chain reaction (RT-qPCR). The RT-qPCR technique is a form of PCR in which the nucleic acid to be amplified is RNA that is first reverse transcribed into cDNA, and the amount of PCR product is measured in each step of the PCR reaction. Since RNA cannot be used as a template for PCR, the first step in gene expression profiling by PCR is to reverse transcribe the RNA template into cDNA, which is then amplified in a PCR reaction. For example, the reverse transcriptase can include avian myeloblastosis virus reverse transcriptase (AMY-RT) or Moloney murine leukemia virus reverse transcriptase (MMLV-RT). Depending on the circumstances and the goal of expression profiling, the reverse transcription step is usually primed using specific primers, random hexamers or oligo-dT primers. For example, GENEAMP can be used TM RNA PCR kit (Perkin Elmer, calif, USA), reverse transcription of the extracted RNA was performed according to the manufacturer's instructions. The resulting cDNA can then be used as a template in subsequent PCR reactions.
One variation of the PCR technique is real-time quantitative PCR (qRT-PCR), which is performed by means of fluorescent probes (i.e.with double labelling)
Figure BDA0003990674580001281
Probe) to measure PCR product accumulation. Quantitative real-time polymerase chain reaction technique refers to PCRA format wherein the amount of PCR product is measured in each step of the PCR reaction. In the examples including Cronin et al, am.J.Pathol.164 (l): 35-42 (2004); and Ma et al, cancer Cell 5, 607-616 (2004). Real-time fluorescent quantitative PCR is compatible with quantitative competitive PCR (in which normalization is performed using internal competitor genes for each target sequence) and/or with quantitative comparative PCR (which performs PCR using normalization genes or housekeeping genes contained in a sample). For further details, see, e.g., held et al, genome Research 6, 986-994 (1996).
The steps of a representative protocol for analyzing gene expression using fixed, paraffin-embedded tissues as a source of RNA, including mRNA isolation, purification, primer extension and amplification, are provided in various published journal articles (e.g., godfrey et al, malec. Diagnostics 2. Briefly, one representative method begins by cutting a portion (e.g., a 10 microgram portion) of a paraffin-embedded tumor tissue sample. RNA is then extracted, and proteins and DNA are removed. After analysis of the RNA concentration, if necessary, RNA repair and/or amplification steps may be included, and the RNA is reverse transcribed using a gene-specific promoter, followed by PCR.
The level of nucleic acid expression determined by amplification-based methods (e.g., RT-qPCR) can be expressed as the cycle threshold (Ct). From this value, the normalized expression level of each gene can be determined using the Δ Ct (dCt) method, as follows: ct (control/reference gene) -Ct (target/target gene) = dCt (target/target gene). Those skilled in the art will appreciate that the dCt value obtained may be a negative dCt value, or may be a positive dCt value. As defined herein, a higher dCt value indicates a higher expression level of the gene of interest relative to a control gene. Conversely, a lower dCt value indicates a lower expression level of the gene of interest relative to the control gene. Where the expression levels of multiple genes have been determined, the expression level of each gene (e.g., expressed as a dCt value) can then be used to determine a single value (e.g., an immune score expression level) that represents the collective or composite expression level of the multiple genes. The immune score expression level can be the mean or median of the dCt values measured for each target/gene of interest. Thus, in some cases, an immune score expression level described herein can be the mean or median of dCt values measured for one or more of the genes listed in any of tables 1 to 17. As defined herein, a higher mean dCt or median dCt value indicates a higher overall expression level of the plurality of target genes relative to the control gene(s). A lower mean dCt or dCt median value indicates a lower overall level of expression of the plurality of target genes relative to the control gene(s). The immune score expression level can then be compared to a reference immune score expression level as further defined herein, as described herein.
In some embodiments, the expression level of a nucleic acid described herein can be determined using a method comprising: (a) Obtaining or providing a sample from an individual, wherein the sample comprises a tumor tissue sample (e.g., a formalin-fixed, paraffin-embedded NSCLC, UC, RCC, or TNBC tumor tissue sample); (b) isolating mRNA from the sample; (c) Reverse transcription of mRNA into cDNA (e.g., for one or more genes listed in any one of tables 1 to 17); (d) Amplifying cDNA using PCR (e.g., for one or more genes listed in any one of tables 1 to 17); and (e) quantifying the nucleic acid expression level (e.g., for one or more genes listed in any one of tables 1 to 17).
Depending on the primers or probes used, one or more (e.g., one or more genes listed in any of tables 1-17) can be detected in a single assay. Further, the assay can be performed across one or more test tubes (e.g., one, two, three, four, five, or six or more test tubes).
In some cases, the method further comprises: (f) The nucleic acid expression level of one or more genes (e.g., one or more genes listed in any of tables 1-17) in the sample is normalized to the expression level of one or more reference genes (e.g., one, two, three, four, five, six, seven, eight, nine or more reference genes, e.g., housekeeping genes). For example, RT-qPCR can be used to analyze the immune score expression levels of genes described herein (e.g., one or more genes listed in any one of tables 1-17) to generate immune score expression levels that reflect normalized mean dCT values for the analyzed genes.
(iii)RNA-seq
In some cases, the level of nucleic acid expression of a gene described herein (e.g., one or more genes listed in any one of tables 1-17) can be detected using RNA-seq. RNA-seq, also known as Whole Transcriptome Shotgun Sequencing (WTSS), refers to sequencing and/or quantifying cDNA using high-throughput sequencing techniques in order to obtain information about the RNA content of a sample. Publications describing RNA-Seq include: wang et al, RNA-Seq: a reliable tool for transcriptors, nature Reviews Genetics 10 (1): 57-63 (1, 2009); ryan et al, bioTechniques 45 (1): 81-94 (2008); and Maher et al, transgenic sequences to detection genes in cander, nature 458 (7234): 97-101 (1 month 2009).
(iv) Sample (I)
The samples described herein can be taken, for example, from individuals suspected of having or diagnosed with cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) and thus may be in need of treatment, or from healthy individuals not suspected of having cancer or determined to not have cancer but a family history of cancer. To assess gene expression, samples, such as those comprising cells or proteins or nucleic acids produced by such cells, can be used in the methods of the invention. The expression level of a gene can be determined by assessing the amount (e.g., absolute amount or concentration) of a marker in a sample (e.g., a tissue sample, e.g., a tumor tissue sample, such as a biopsy sample). In addition, the gene level in the bodily fluid or excreta containing detectable gene levels can be assessed. Body fluids or secretions useful as samples in the present invention include, for example, blood, urine, saliva, stool, pleural fluid, lymph, sputum, ascites, prostatic fluid, cerebrospinal fluid (CSF) or any other body fluid or derivative thereof. The term "blood" is intended to include whole blood, plasma, serum or any derivative of blood. In cases where invasive sampling methods are inappropriate or inconvenient, it may sometimes be preferable to assess genes in such body fluids or excreta. In other embodiments, tumor tissue samples are preferred.
The sample can be a frozen sample, a fresh sample, a fixed (e.g., formalin fixed) sample, a centrifuged and/or embedded (e.g., paraffin embedded) sample, and the like. Prior to assessing the amount of one or more markers in a sample, the cell sample may be subjected to various well-known post-collection preparation and storage techniques (e.g., nucleic acid and/or protein extraction, immobilization, storage, freezing, ultrafiltration, concentration, evaporation, centrifugation, etc.). Likewise, the biopsy sample may also be processed by post-collection preparation and storage techniques (e.g., fixation, such as formalin fixation).
In some embodiments, the sample is a blood sample. In another instance, the sample is used in a diagnostic assay such as the diagnostic assay or diagnostic method of the invention. In some cases, the sample is obtained from a primary or metastatic tumor. Tissue biopsies are commonly used to obtain representative tumor tissue masses. Alternatively, tumor cells may be obtained indirectly in the form of tissues or body fluids known or believed to contain the tumor cells of interest. For example, samples of lung cancer lesions may be obtained by resection, bronchoscopy, fine needle puncture, bronchial brushing, or sputum, pleural fluid, or blood. Genes or gene products can be detected from cancer or tumor tissue or other body samples (e.g., urine, sputum, serum, or plasma). The same techniques discussed above for detecting a target gene or gene product in a cancerous sample can be applied to other body samples. Cancer cells may be shed from cancerous lesions and appear in such body samples. By screening such body samples, a simple early diagnosis of these cancers can be made. In addition, by testing for target genes or gene products in such body samples, the progress of the treatment can be more easily monitored.
In some cases, the sample from the individual is a tissue sample, a whole blood sample, a plasma sample, a serum sample, or a combination thereof. In some cases, the sample is a tissue sample. In some cases, the sample is a tumor tissue sample. In some cases, the sample is obtained prior to treatment with a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)). In some cases, the tissue sample is a Formalin Fixed and Paraffin Embedded (FFPE) sample, an archived sample, a fresh sample, or a frozen sample.
In some cases, the sample from the individual is a tissue sample. In some cases, the tissue sample is a tumor tissue sample (e.g., biopsy). In some cases, the tumor tissue sample comprises tumor cells, tumor infiltrating immune cells, stromal cells, or a combination thereof. In some cases, the tissue sample is lung tissue. In some cases, the tissue sample is bladder tissue. In some cases, the tissue sample is kidney tissue. In some cases, the tissue sample is breast tissue. In some cases, the tissue sample is skin tissue. In some cases, the tissue sample is pancreatic tissue. In some cases, the tissue sample is stomach tissue. In some cases, the tissue sample is esophageal tissue. In some cases, the tissue sample is mesothelial tissue. In some cases, the tissue sample is thyroid tissue. In some cases, the tissue sample is colorectal tissue. In some cases, the tissue sample is head or neck tissue. In some cases, the tissue sample is osteosarcoma tissue. In some cases, the tissue sample is prostate tissue. In some cases, the tissue sample is ovarian tissue, HCC (liver), blood cells, lymph nodes, or bone/bone marrow.
In some cases, the tumor tissue sample is extracted from a malignant tumor (i.e., cancer). In some cases, the cancer is a solid tumor or a non-solid tumor or a soft tissue tumor. Examples of soft tissue tumors include leukemia (e.g., chronic myelogenous leukemia, acute myelogenous leukemia, adult acute lymphocytic leukemia, acute myelogenous leukemia, mature B-cell acute lymphocytic leukemia, chronic lymphocytic leukemia, multi-lymphocytic leukemia, or hairy cell leukemia) or lymphoma (e.g., non-hodgkin's lymphoma, cutaneous T-cell lymphoma, or hodgkin's disease). Solid tumors include cancers of any body tissue other than the blood, bone marrow, or lymphatic system. Solid tumors can be further divided into epithelial cell-derived and non-epithelial cell-derived. Examples of epithelial solid tumors include gastrointestinal cancer, colon cancer, colorectal cancer (e.g., basal-like colorectal cancer), breast cancer, prostate cancer, lung cancer, kidney cancer, liver cancer, pancreatic cancer, ovarian cancer (e.g., endometrioid ovarian cancer), head and neck cancer, oral cancer, stomach cancer, duodenal cancer, small intestine cancer, large intestine cancer, rectal cancer, gallbladder cancer, lip cancer, nasopharyngeal cancer, skin cancer, uterine cancer, cancer of the male reproductive organ, cancer of the urinary organ (e.g., urothelial cancer, dysplastic urothelial cancer, transitional cell cancer), bladder cancer, and skin cancer. Solid tumors of non-epithelial origin include sarcomas, brain tumors and bone tumors. In some cases, the cancer is NSCLC. In some cases, the cancer is second or third line locally advanced or metastatic non-small cell lung cancer. In some cases, the cancer is adenocarcinoma. In some cases, the cancer is squamous cell carcinoma.
(v) RNA extraction
mRNA can be isolated from a target sample prior to detecting the level of nucleic acid. In some cases, the mRNA is total RNA isolated from a tumor or tumor cell line or a normal tissue or cell line. RNA can be isolated from various tumor tissues (including breast, lung, colon, prostate, brain, liver, kidney, pancreas, stomach, gall bladder, spleen, thymus, testis, ovary, uterus, etc.), corresponding normal tissues or tumor cell lines. If the source of the mRNA is a primary tumor, the mRNA can be extracted from frozen or archived paraffin-embedded and fixed (e.g., formalin-fixed) tissue samples. General methods for extracting mRNA are well known in the art and are disclosed in standard textbooks of molecular biology, including: ausubel et al, current Protocols of Molecular Biology, john Wiley and Sons (1997). Methods for extracting RNA from paraffin-embedded tissues are disclosed, for example, in the following documents: rupp and Locker, lab invest.56: A67 (1987); and De Andres et al, bio technologies 18 (1995). In particular, commercial manufacturers (e.g., qiagen) purification kits, buffer sets, and proteases can be used RNA isolation was performed according to the manufacturer's instructions. For example, total RNA can be extracted from cells in culture using Qiagen RNeasy mini-columns. Other commercially available RNA isolation kits include
Figure BDA0003990674580001331
Complete set of DNA and RNA purification kits (
Figure BDA0003990674580001332
Madison, wis.) and paraffin block RNA isolation kit (Ambion, inc.). For example, RNA Stat-60 (TelTest) can be used to isolate total RNA from tissue samples. For example, cesium chloride density gradient centrifugation can also be used to isolate RNA prepared from tumor tissue samples.
(vi) Immune score expression level
The immune score expression level may reflect the expression level of one or more genes described herein (e.g., one or more genes listed in any one of tables 1-17). In some cases, to determine the immune score expression level, the detected expression level of each gene is normalized using any of the standard normalization methods known in the art. One skilled in the art will appreciate that the normalization method used may depend on the gene expression method used (e.g., in the case of the RT-qPCR method, normalization may be performed using one or more housekeeping genes, but in the case of the RNA-seq method, the whole genome or substantially the whole genome may be used as a normalization baseline). For example, the detected expression levels of each gene tested can be normalized for differences in the amount of one or more genes tested, variability in the quality of the sample used, and/or variability between test runs.
In some cases, normalization can be achieved by detecting the expression of a particular normalization gene or genes (including one or more reference genes, such as housekeeping genes). For example, in some cases, the expression levels of nucleic acids detected using the methods described herein (e.g., for one or more genes listed in any one of tables 1-17) can be normalized to the expression levels of one or more reference genes (e.g., one, two, three, four, five, six, seven, eight, nine, or more reference genes, such as housekeeping genes). Alternatively, normalization can be based on the average signal or median of the signals for all genes tested. The normalized amount of tumor mRNA measured from the subject can be compared to the amount found at a reference immune score expression level on a gene-by-gene basis. The presence and/or expression level/amount measured in a particular subject sample to be analyzed will fall within a certain percentile of this range, which can be determined by methods well known in the art.
In some cases, the level of expression detected for each gene tested is not normalized for determining the level of immune score expression.
The immune score expression level may reflect a single gene or a collective or composite expression level of multiple genes described herein (e.g., for one or more genes listed in any one of tables 1-17). Any statistical method known in the art can be used to determine the level of expression of an immune score.
For example, the immune score expression level may reflect a median expression level, an average expression level, or a numerical value reflecting a collective Z-score expression level for a combination of genes determined (e.g., for one or more genes listed in any of tables 1-17).
In some cases, the immune score expression level reflects a median normalized expression level, an average normalized expression level, or a numerical value reflecting a collective Z-score normalized expression level for the combination of genes determined (e.g., for one or more genes listed in any one of tables 1-17).
For example, the immune score expression level may reflect the average (mean) of the expression levels of each gene in a combination of two or more genes listed in any one of tables 1 to 17. In some cases, the immune score expression level reflects an average (mean) of the normalized expression levels of each gene in a combination of two or more genes listed in any one of tables 1 to 17 (e.g., normalized to a reference gene, such as a housekeeping gene). In some cases, the immune score expression level reflects the median of the expression level of each gene in a combination of two or more genes listed in any one of tables 1 to 17. In some cases, the immune score expression level reflects the median value of the normalized expression level of each gene in a combination of two or more genes listed in any one of tables 1 to 17 (e.g., normalized to a reference gene, such as a housekeeping gene). In some cases, the immune score expression level reflects the Z score of each gene in a combination of two or more genes listed in any one of tables 1 to 17.
(vii) Reference immune score expression level
The reference immune score expression level can be a value obtained by analyzing any of the reference populations described herein. In some cases, the reference immune score expression level can be a "cut-off value selected based on the reference immune score expression level that divides the reference population into different subsets, e.g., subsets that have a significant difference (e.g., a statistically significant difference) in therapeutic response to PD-L1 axis binding antagonist therapy and non-PD-L1 axis binding antagonist therapy. In such cases, relative therapeutic response may be assessed based on progression-free survival (PFS) or Overall Survival (OS), e.g., expressed as a risk ratio (HR) (e.g., progression-free survival HR (PFS HR) or overall survival HR (OS HR)).
In certain instances, the reference immune score expression level is an immune score expression level of one or more genes listed in any one of tables 1 to 17 in the reference population that, based on a significant difference between the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist and the responsiveness of the individual to treatment with the non-PD-L1 axis binding antagonist that is greater than the reference immune score expression level (i.e., greater than a cutoff value), significantly (e.g., statistically) distinguishes a first subset of individuals in the reference population that have received treatment with the PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., attlizumab) or a PD-1 binding antagonist (e.g., anti-PD-1 antibody)) from a second subset of individuals in the same reference population that have received treatment with the non-PD-L1 axis binding antagonist without the PD-L1 axis binding antagonist, wherein the individual's responsiveness to treatment with the PD-L1 axis binding antagonist is significantly improved relative to the individual's treatment with the non-PD-L1 axis binding antagonist.
In some cases, the reference immune score expression level is an immune score expression level of one or more genes listed in any one of tables 1 to 17 in the reference population that substantially best distinguishes a first subset of individuals in the reference population that have been treated with a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as alemtuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) from a second subset of individuals in the same reference population that have been treated with a non-PD-L1 axis binding antagonist that does not contain a PD-L1 axis binding antagonist, based on a substantially maximal difference between the individual's responsiveness to treatment with the PD-L1 axis binding antagonist and the individual's responsiveness to treatment with the non-PD-L1 axis binding antagonist (i.e., above a threshold), wherein the individual's responsiveness to treatment with the PD-L1 axis binding antagonist is statistically significantly improved (e.g., has a statistically significant response) to treatment with the non-PD-L1 axis binding antagonist.
In certain particular instances, the reference immune score expression level is an immune score expression level of one or more genes listed in any one of tables 1 to 17 in the reference population that is based on a maximum difference between the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist therapy and the responsiveness of the individual to treatment with the non-PD-L1 axis binding antagonist therapy that is greater than the reference immune score expression level (i.e., greater than a cutoff value), that best distinguishes a first subset of individuals in the reference population that have received treatment with the PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., alemtuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) from a second subset of individuals in the same reference population that have received treatment with the non-PD-L1 axis binding antagonist without the PD-L1 axis binding antagonist, wherein the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist therapy is significantly (e.g., statistically significantly improved) relative to treatment with the non-PD-L1 axis binding antagonist.
In certain instances, the reference immune score expression level is an immune score expression level of one or more genes listed in any one of tables 1 to 17 in the reference population that, based on a significant difference below the reference immune score expression level (i.e., below a threshold) between the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist and the responsiveness of the individual to treatment with the non-PD-L1 axis binding antagonist, visibly (e.g., statistically significant) distinguishes a first subset of individuals in the reference population that have been treated with the PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as alemtuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) from a second subset of individuals in the same reference population that have been treated with the non-PD-L1 axis binding antagonist without PD-L1 axis binding, wherein the responsiveness of the individual to treatment with the non-PD-L1 axis binding antagonist is statistically significantly improved (e.g., statistically significantly improved) relative to the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist.
In some cases, the reference immune score expression level is an immune score expression level of one or more genes listed in any one of tables 1 to 17 in the reference population that substantially optimally distinguishes a first subset of individuals in the reference population that have received treatment with a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., alemtuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) from a second subset of individuals in the same reference population that have received treatment with a non-PD-L1 axis binding antagonist that does not contain a PD-L1 axis binding antagonist, based on a substantially maximal difference between the individual's responsiveness to treatment with the PD-L1 axis binding antagonist and the individual's responsiveness to treatment with a non-PD-L1 axis binding antagonist (e.g., below a reference immune score expression level (i.e., below a cut-off value), wherein the individual's responsiveness to treatment with the PD-L1 axis binding antagonist is statistically significantly improved (e.g., has a statistically significant response to treatment with the PD-L1 axis binding antagonist).
In certain particular instances, the reference immune score expression level is an immune score expression level of one or more genes listed in any one of tables 1 to 17 in the reference population that is based on a maximum difference below the reference immune score expression level (i.e., below a threshold) between the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist therapy and the responsiveness of the individual to treatment with the non-PD-L1 axis binding antagonist therapy that best distinguishes a first subset of individuals in the reference population that have received treatment with the PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., alemtuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) from a second subset of individuals in the same reference population that have received treatment with the non-PD-L1 axis binding antagonist therapy that does not contain the PD-L1 axis binding antagonist, wherein the responsiveness of the individual to treatment with the non-PD-L1 axis binding antagonist therapy is significantly (e.g., statistically significantly) improved relative to the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist.
The reference immune score expression level can be determined from any number of individuals in a reference population and/or any number of reference samples (e.g., reference cells, reference tissues, control samples, control cells, or control tissues). The reference sample may be a single sample or a combination of multiple samples. Reference immune score expression levels based on reference samples can be based on any number of reference samples (e.g., 2 or more, 5 or more, 10 or more, 50 or more, 100 or more, 500 or more, or 1000 or more reference samples). In some cases, the reference sample comprises pooled mRNA samples extracted from samples obtained from multiple individuals. Further, a reference immune score expression level based on a reference population or sample thereof can be based on any number of individuals in the reference population (e.g., 2 or more, 5 or more, 10 or more, 50 or more, 100 or more, 500 or more, or 1000 or more individuals in the reference population). The reference immune score expression level can be determined from the measurements based on multiple samples or multiple individuals in the reference population using any statistical method known in the art. See, for example: sokal R.R. and Rholf, F.J. (1995) "Biometry: the principles and practice of statistics in biological research", W.H.Freeman and Co., N.Y..
(viii) Reference population
The reference immune score expression level may reflect one or more expression levels of one or more genes described herein (e.g., one or more genes listed in any one of tables 1-17) in one or more reference populations (or reference samples), or a pre-specified reference value.
In some cases, the reference immune score expression level is an immune score expression level of one or more genes listed in any one of tables 1 to 17 in the reference population.
In some cases, the reference population is a population of individuals with cancer. In some cases, the reference population is a population of individuals with lung cancer (e.g., NSCLC). In some cases, the reference population is a population of individuals suffering from kidney cancer (e.g., RCC). In some cases, the reference population is a population of individuals with bladder cancer (e.g., UC). In some cases, the reference population is a population of individuals with breast cancer (e.g., TNBC). In some cases, the reference population is a population of individuals not suffering from cancer.
Further, the reference population can include one or more subsets (e.g., one or more, two or more, three or more, four or more, five or more, six or more, seven or more, eight or more, nine or more, or ten or more subsets) of individuals.
In some cases, the reference population is a population of individuals having cancer, wherein the population of individuals comprises a subset of individuals that have received treatment with at least one dose (e.g., at least one dose, at least two doses, at least three doses, at least four doses, at least five doses, at least six doses, at least seven doses, at least eight doses, at least nine doses, or at least ten doses, or more than ten doses) of therapy including a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., altlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)). In some cases, a therapy comprising a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) is a monotherapy. In other instances, the therapy comprising a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) is a combination therapy comprising at least one additional therapeutic agent (e.g., an anti-cancer therapy (e.g., an anti-tumor agent, a chemotherapeutic agent, a growth inhibitory agent, a cytotoxic agent, radiation therapy, or a combination thereof)) in addition to the PD-L1 axis binding antagonist.
In some cases, the reference population is a population of individuals with cancer, wherein the population of individuals includes a population of individuals that have received treatment with therapy that does not include a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) non-PD-L1 axis binding antagonist therapy (e.g., an anti-cancer therapy (e.g., an anti-tumor agent, a chemotherapeutic agent, a growth inhibitory agent, a cytotoxic agent, radiation therapy, or a combination thereof)).
In some cases, the reference population includes a combination of individuals from different subsets. For example, in some cases, the reference population may be a population of individuals with cancer, including: (i) A first subset of individuals who have received treatment with a PD-L1 axis binding antagonist therapy (e.g., PD-L1 binding antagonist therapy) comprising a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)); and (ii) a second subset of individuals treated with a non-PD-L1 axis binding antagonist therapy (e.g., a non-PD-L1 binding antagonist therapy) that does not include a PD-L1 axis binding antagonist (e.g., an anti-cancer therapy (e.g., an anti-tumor agent, a chemotherapeutic agent, a growth inhibitory agent, a cytotoxic agent, radiation therapy, or a combination thereof).
Methods of treatment and therapeutic uses
Also provided herein are methods, medicaments, and uses thereof for treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) comprising administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., alemtuzumab), or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) based on the presence and/or expression level of one or more of any one of the biomarkers disclosed herein having been measured in a sample from the individual.
Any of the methods provided herein can comprise determining the presence and/or expression level of any of the biomarkers disclosed herein. In some cases, any of the methods provided herein can comprise administering a PD-L1 binding antagonist to an individual based on a previously determined presence and/or expression level of any of the biomarkers disclosed herein. In other instances, any of the methods provided herein can comprise administering a PD-L1 binding antagonist to an individual prior to determining the presence and/or expression level of any of the biomarkers disclosed herein.
Any of the methods, medicaments, and uses can include or involve any of the PD-L1 axis binding antagonists disclosed herein (e.g., in section IV).
For example, a biomarker may comprise the presence and/or level of expression of a biomarker listed in any one of tables 1 to 17 in a sample obtained from an individual; the presence of TLS in a sample obtained from an individual; the number of B cells in a sample obtained from the individual; the presence of clonally expanded B cells in a sample from an individual; and/or combinations thereof. Any suitable sample may be used, for example, any sample type disclosed herein, including tumor samples.
For example, provided herein is a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), renal cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising: (a) Determining the expression level of one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, or 20) genes listed in table 1 in a sample from the individual, wherein the immune score expression level of the one or more genes in the sample is determined to be higher than a reference immune score expression level of the two or more genes; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In another example, provided herein is a method of treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have an immune score expression level of one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, or 20) genes listed in table 1 in a sample from the individual that is higher than a reference immune score expression level of the one or more genes, comprising administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., an anti-PD-L1 antibody, such as attrituximab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
Any suitable immuno-score reference expression level can be used. In some cases, the immune score reference expression level is an immune score expression level of one or more genes in a reference population. In some cases, the reference population is a population of individuals with cancer. In some cases, the population of individuals includes a first subset of individuals who have received treatment with a PD-L1 axis binding antagonist and a second subset of individuals who have received treatment with a therapy that does not contain a PD-L1 axis binding antagonist. In some cases, the reference immune score expression level visibly distinguishes between the first subset of individuals and each of the second subset of individuals based on a significant difference between the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist and the responsiveness of the individual to treatment with the therapy that does not contain the PD-L1 axis binding antagonist above the reference immune score expression level, wherein the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist is significantly improved relative to the responsiveness of the individual to treatment with the therapy that does not contain the PD-L1 axis binding antagonist. In some cases, the therapy without the PD-L1 axis binding antagonist comprises an anti-tumor agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, or a combination thereof. In some cases, the therapy without the PD-L1 axis binding antagonist comprises a chemotherapeutic agent. In some cases, the chemotherapeutic agent is docetaxel. In some cases, responsiveness to treatment comprises prolongation of OS, prolongation of progression-free survival (PFS), or an increase in the determined optimal overall response (BCOR). In some cases, responsiveness to treatment includes an extension of Overall Survival (OS). In some cases, the reference immune score expression level is the median of the expression levels of each of the one or more genes in the reference population. In some cases, the median expression level is the median of the mean Z scores for the expression levels of each of the one or more genes in the reference population.
Any suitable sample may be used. In some cases, the sample is a tissue sample, a cell sample, a whole blood sample, a plasma sample, a serum sample, or a combination thereof. In some cases, the tissue sample is a tumor tissue sample. In some cases, the tumor sample is a tumor tissue sample. In some cases, the tumor tissue sample comprises tumor cells, tumor infiltrating immune cells, stromal cells, NAT cells, or a combination thereof. In some cases, the tumor tissue sample is an FFPE sample, an archived sample, a fresh sample, or a frozen sample. In some cases, the tumor tissue sample is an FFPE sample.
The cancer may be any suitable type of cancer. In some cases, the cancer is lung cancer, kidney cancer, bladder cancer, breast cancer, colorectal cancer, ovarian cancer, pancreatic cancer, gastric cancer, esophageal cancer, mesothelioma, melanoma, head and neck cancer, thyroid cancer, sarcoma, prostate cancer, glioblastoma, cervical cancer, thymus cancer, leukemia, lymphoma, myeloma, mycosis fungoides, merkel cell carcinoma, or hematological malignancy. In some cases, the cancer is lung, kidney, bladder, or breast cancer. In some cases, the lung cancer is non-small cell lung cancer (NSCLC). In some cases, the NSCLC is non-squamous NSCLC. In some cases, the NSCLC is squamous NSCLC.
In some cases, the benefit comprises a prolongation of OS in the individual, a prolongation of PFS in the individual, and/or an improvement in BCOR in the individual as compared to treatment without the PD-L1 axis binding antagonist. In some cases, the benefit includes an extension of the Overall Survival (OS) of the individual as compared to treatment without the PD-L1 axis binding antagonist.
A.B cell characteristics
(i) Gene signature associated with B cells
In some aspects, the methods provided herein can involve administering a PD-L1 axis binding antagonist to an individual based on the expression level of one or more genes in the B cell signature. Any suitable B cell characteristics may be used. For example, a B cell characteristic can include one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) genes listed in table 2.
For example, provided herein is a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), renal cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising: (a) Determining the expression level of one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual, wherein the immune score expression level of the one or more genes in the sample is determined to be higher than a reference immune score expression level of the one or more genes; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In another example, provided herein is a method of treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have an immune score expression level of one or more of genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) in a sample from the individual that is higher than a reference immune score expression level of the one or more genes, the method comprising administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., attritol) or a PD-1 binding antagonist (e.g., anti-PD 1 antibody)).
In yet another example, provided herein is a PD-L1 axis binding antagonist for use in a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising: (a) Determining the expression level of one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual, wherein the immune score expression level of the one or more genes in the sample is determined to be higher than a reference immune score expression level of the one or more genes; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In another example, provided herein is a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for use in treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have an immune score expression level of one or more of the genes CD79A, CD19, BANK1, jcain, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) in a sample from the individual that is higher than a reference immune score expression level of the one or more genes.
In yet another example, provided herein is use of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for the manufacture of a medicament for use in a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) comprising: (a) Determining the expression level of one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual, wherein the immune score expression level of the one or more genes in the sample is determined to be higher than a reference immune score expression level of the one or more genes; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another example, also provided herein is the use of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for the manufacture of a medicament for treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have one or more of the genes CD79A, CD19, BANK1, jcain, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) in a sample from the individual at an immune expression level that is greater than a reference immune score for the one or more genes.
In some cases, the method comprises determining the expression level of one of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB 1.
In some cases, the method comprises determining the expression level of CD 79A.
In some cases, the method comprises determining the expression level of CD 19.
In some cases, the method comprises determining the expression level of BANK 1.
In some cases, the method comprises determining the expression level of JCHAIN.
In some cases, the method includes determining the expression level of SLAMF 7.
In some cases, the method includes determining an expression level of BTK.
In some cases, the method comprises determining the expression level of TNFRSF 17.
In some cases, the method comprises determining the expression level of IGJ.
In some cases, the method includes determining the expression level of IGLL 5.
In some cases, the method comprises determining the expression level of RBPJ.
In some cases, the method comprises determining an expression level of MZB 1.
In some cases, the expression level of one of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 has been determined.
In some cases, the expression level of CD79A has been determined.
In some cases, the expression level of CD19 has been determined.
In some cases, the expression level of BANK1 has been determined.
In some cases, the expression level of JCHAIN has been determined.
In some cases, the expression level of SLAMF7 has been determined.
In some cases, the expression level of BTK has been determined.
In some cases, the expression level of TNFRSF17 has been determined.
In some cases, the expression level of IGJ has been determined.
In some cases, the expression level of IGLL5 has been determined.
In some cases, the expression level of RBPJ has been determined.
In some cases, the expression level of MZB1 has been determined.
Any suitable immuno-score reference expression level can be used. In some cases, the immune score reference expression level is an immune score expression level of one or more genes in the reference population. In some cases, the reference population is a population of individuals with cancer. In some cases, the population of individuals includes a first subset of individuals who have received treatment with a PD-L1 axis binding antagonist and a second subset of individuals who have received treatment with a therapy that does not contain a PD-L1 axis binding antagonist. In some cases, the reference immune score expression level visibly differentiates each of the first subset of individuals from the second subset of individuals based on a significant difference between the individual's responsiveness to treatment with a PD-L1 axis binding antagonist and the individual's responsiveness to treatment with a therapy that does not contain a PD-L1 axis binding antagonist, above the reference immune score expression level, wherein the individual's responsiveness to treatment with a PD-L1 axis binding antagonist is significantly improved relative to the individual's responsiveness to treatment with a therapy that does not contain a PD-L1 axis binding antagonist. In some cases, the therapy without the PD-L1 axis binding antagonist comprises an anti-neoplastic agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, or a combination thereof. In some cases, the therapy without the PD-L1 axis binding antagonist comprises a chemotherapeutic agent. In some cases, the chemotherapeutic agent is docetaxel. In some cases, responsiveness to treatment comprises prolongation of OS, prolongation of PFS, or an increase in BCOR. In some cases, responsiveness to treatment includes an extension of Overall Survival (OS). In some cases, the reference immune score expression level is the median of the expression levels of each of the one or more genes in the reference population. In some cases, the median expression level is the median of the mean Z scores for the expression levels of each of the one or more genes in the reference population.
For example, provided herein is a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising: (a) Determining in a sample from the individual the expression level of one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1, wherein determining the immune score expression level of the one or more genes in the sample is greater than a reference immune score expression level of the one or more genes identifies the individual as an individual likely to benefit from treatment comprising a PD-L1 axis binding antagonist, wherein the benefit comprises a prolonged OS in the individual as compared to treatment without the PD-L1 axis binding antagonist; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In another example, provided herein is a method of treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have an immune score expression level of one or more of genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, rbj, and MZB1 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) in a sample from the individual that is higher than a reference immune score expression level of the one or more genes, the method comprising administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., an anti-PD-L1 antibody, e.g., attritrin antagonist) or a PD-1 binding antagonist (e.g., a PD-1 axis binding antagonist), wherein the increased immune score expression level of the individual is greater than the reference immune score of the reference gene, wherein the individual's increased immune system comprising the use of the one or more of the individual.
In yet another example, provided herein is a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for use in a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising: (a) Determining in a sample from the individual the expression level of one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1, wherein determining the immune score expression level of the one or more genes in the sample is greater than a reference immune score expression level of the one or more genes identifies the individual as an individual likely to benefit from treatment comprising a PD-L1 axis binding antagonist, wherein the benefit comprises a prolonged OS in the individual as compared to treatment without the PD-L1 axis binding antagonist; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another example, provided herein is a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as altlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for use in treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have an immune score for one or more of genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) in a sample from the individual that is higher than a reference immune score for the individual that would benefit from the use of the reference immune score for the one or more genes, wherein the individual has an immune score that is higher than a reference level of expression of the individual that would benefit from the increased expression of the one or more genes.
In yet another example, provided herein is use of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for the manufacture of a medicament for use in a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) comprising: (a) Determining in a sample from the individual the expression level of one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1, wherein determining the immune score expression level of the one or more genes in the sample is greater than a reference immune score expression level of the one or more genes identifies the individual as an individual likely to benefit from treatment comprising a PD-L1 axis binding antagonist, wherein the benefit comprises a prolonged OS in the individual as compared to treatment without the PD-L1 axis binding antagonist; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another example, also provided herein is the use of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for the manufacture of a medicament for treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have one or more of the genes CD79A, CD19, BANK1, jcha in, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) in a sample from the individual, wherein the individual has an immune expression score that is higher than a reference immune expression score for the one or more genes, wherein the identification of the subject's immune expression score is likely to benefit from use of the PD-L1 binding antagonist.
In some cases, the genes include two or more of CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB 1.
For example, provided herein is a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising: (a) Determining in a sample from the individual the expression levels of two or more (e.g., 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1, wherein the two or more genes in the sample are determined to have an immune score expression level that is higher than a reference immune score expression level for the two or more genes; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In another example, provided herein is a method of treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have an immune score expression level of two or more of genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, rbj, and MZB1 (e.g., 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) in a sample from the individual that is higher than a reference immune score expression level of the two or more genes, the method comprising administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., attritol monoclonal antibody) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In yet another example, provided herein is a PD-L1 axis binding antagonist for use in a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising: (a) Determining in a sample from the individual the expression level of two or more (e.g., 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1, wherein the determination of the immune score expression level of the two or more genes in the sample is higher than the reference immune score expression level of the two or more genes; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In another example, provided herein is a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as altlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for use in treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have an immune expression level of two or more (e.g., 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB 1) in a sample from the individual that is higher than a reference immune score for the two or more genes.
In yet another example, provided herein is use of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for the manufacture of a medicament for use in a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) comprising: (a) Determining the expression level of two or more (e.g., 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual, wherein the immune score expression level of the two or more genes in the sample is determined to be higher than a reference immune score expression level of the two or more genes; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another example, also provided herein is the use of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for the manufacture of a medicament for treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have an immune score expression level of two or more of the genes CD79A, CD19, BANK1, jcain, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual that is higher than a reference immune expression level of the two or more genes.
Any combination of B cell signature genes can be determined. For example, the combination may include two genes selected from CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1, e.g., any one of the combinations listed in table 3. In another example, the combination can include three genes selected from CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1, e.g., any one of the combinations listed in table 4. In another example, the combination can include four genes selected from CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1, e.g., any one of the combinations listed in table 5. In another example, the combination can include five genes selected from CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1, e.g., any one of the combinations listed in table 6. In another example, the combination can include six genes selected from CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1, e.g., any one of the combinations listed in table 7. In another example, the combination may include seven genes selected from CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1, e.g., any one of the combinations listed in table 8.
In some cases, the genes include CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1.
In some cases, the expression level is a nucleic acid expression level. For example, in some cases, the nucleic acid expression level is an mRNA expression level. mRNA expression levels can be determined using any suitable method (e.g., any method disclosed herein). In some cases, mRNA expression levels are determined by RNA-seq, RT-qPCR, multiplex qPCR or RT-qPCR, microarray analysis, SAGE, massARRAY technology, FISH, or combinations thereof. In some cases, mRNA expression levels are detected using RNA-seq.
In other cases, the expression level is a protein expression level. Protein expression levels can be determined using any suitable method (e.g., any of the methods disclosed herein). In some cases, protein expression levels are determined by IHC, immunofluorescence, mass spectrometry, flow cytometry, and western blot, or a combination thereof.
Any suitable sample may be used. In some cases, the sample is a tissue sample, a cell sample, a whole blood sample, a plasma sample, a serum sample, or a combination thereof. In some cases, the tissue sample is a tumor tissue sample. In some cases, the tumor sample is a tumor tissue sample. In some cases, the tumor tissue sample comprises tumor cells, tumor infiltrating immune cells, stromal cells, NAT cells, or a combination thereof. In some cases, the tumor tissue sample is an FFPE sample, an archived sample, a fresh sample, or a frozen sample. In some cases, the tumor tissue sample is an FFPE sample.
The cancer may be any suitable type of cancer. In some cases, the cancer is lung cancer, kidney cancer, bladder cancer, breast cancer, colorectal cancer, ovarian cancer, pancreatic cancer, stomach cancer, esophageal cancer, mesothelioma, melanoma, head and neck cancer, thyroid cancer, sarcoma, prostate cancer, glioblastoma, cervical cancer, thymus cancer, leukemia, lymphoma, myeloma, mycosis fungoides, merkel cell carcinoma, or a hematological malignancy. In some cases, the cancer is lung, kidney, bladder, or breast cancer. In some cases, the lung cancer is NSCLC. In some cases, the NSCLC is non-squamous NSCLC. In some cases, the NSCLC is squamous NSCLC.
In some cases, the benefit comprises a prolongation of OS in the individual, a prolongation of PFS in the individual, and/or an improvement in BCOR in the individual as compared to treatment without the PD-L1 axis binding antagonist. In some cases, the benefit includes an extension of the Overall Survival (OS) of the individual as compared to treatment without the PD-L1 axis binding antagonist.
(ii) Gene signature associated with plasma B cells
In some aspects, the methods provided herein can involve administering a PD-L1 axis binding antagonist to an individual based on the expression level of one or more genes in a plasma B cell signature. Any suitable plasma B cell characteristics may be used. For example, a plasma B cell characteristic can include one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, or 14) genes listed in table 9.
For example, provided herein is a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising: (a) Determining in a sample from the individual the expression level of one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, or 14) of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5, wherein the determination of the immune expression level of the one or more genes in the sample is higher than the reference immune score expression level of the one or more genes; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In another example, provided herein is a method of treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have an immune expression level of one or more of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, or 14) in a sample from the individual that is higher than a reference immune expression level of the one or more genes, the method comprising administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., binding to an anti-PD antibody (e.g., attorneol 1-PD), such as an anti-PD 1-PD antibody).
In yet another example, provided herein is a PD-L1 axis binding antagonist for use in a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising: (a) Determining in a sample from the individual the expression level of one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, or 14) of the genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5, wherein the determination of the immune expression level of the one or more genes in the sample is higher than the reference immune score expression level of the one or more genes; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In another example, provided herein is a PD-L1 axis binding antagonist (e.g., PD-L1 binding antagonist (e.g., anti-PD-L1 antibody, e.g., altlizumab)) for use in treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have one or more of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, or 14) in a sample from the individual at a high immune score or at one or more immune expression level of the immune score.
In yet another example, provided herein is the use of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for the manufacture of a medicament for use in a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., NSCLC), renal cancer (e.g., rcu), and breast cancer (e.g., TNBC)) comprising: (a) Determining in a sample from the individual the expression level of one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, or 14) of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5, wherein the determination of the immune expression level of the one or more genes in the sample is higher than the reference immune score expression level of the one or more genes; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another example, also provided herein is the use of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attrituzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for the manufacture of a medicament for treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have one or more of the genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 (e.g., one or more of 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 12, 13, or more immune scores) in a sample from the individual at a high immune expression level of the reference.
In some cases, the method includes determining an expression level of one of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
In some cases, the method comprises determining an expression level of MZB 1.
In some cases, the method comprises determining an expression level of DERL 3.
In some cases, the method comprises determining an expression level of JSRP 1.
In some cases, the method comprises determining the expression level of TNFRSF 17.
In some cases, the method comprises determining the expression level of SLAMF 7.
In some cases, the method comprises determining the expression level of IGHG 2.
In some cases, the method comprises determining the expression level of IGHGP.
In some cases, the method comprises determining the expression level of IGLV 3-1.
In some cases, the method comprises determining the expression level of IGLV 6-57.
In some cases, the method comprises determining the expression level of IGHA 2.
In some cases, the method includes determining the expression level of IGKV 4-1.
In some cases, the method includes determining the expression level of IGKV 1-12.
In some cases, the method comprises determining the expression level of IGLC 7.
In some cases, the method includes determining the expression level of IGLL 5.
In some cases, the expression level of one of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 has been determined.
In some cases, the expression level of MZB1 has been determined.
In some cases, the expression level of DERL3 has been determined.
In some cases, the expression level of JSRP1 has been determined.
In some cases, the expression level of TNFRSF17 has been determined.
In some cases, the expression level of SLAMF7 has been determined.
In some cases, the expression level of IGHG2 has been determined.
In some cases, the expression level of IGHGP has been determined.
In some cases, the expression level of IGLV3-1 has been determined.
In some cases, the expression level of IGLV6-57 has been determined.
In some cases, the expression level of IGHA2 has been determined.
In some cases, the expression level of IGKV4-1 has been determined.
In some cases, the expression level of IGKV1-12 has been determined.
In some cases, the expression level of IGLC7 has been determined.
In some cases, the expression level of IGLL5 has been determined.
Any suitable immuno-score reference expression level can be used. In some cases, the immune score reference expression level is an immune score expression level of one or more genes in the reference population. In some cases, the reference population is a population of individuals with cancer. In some cases, the population of individuals includes a first subset of individuals who have received treatment with a PD-L1 axis binding antagonist and a second subset of individuals who have received treatment with a therapy that does not contain a PD-L1 axis binding antagonist. In some cases, the reference immune score expression level visibly differentiates each of the first subset of individuals from the second subset of individuals based on a significant difference between the individual's responsiveness to treatment with a PD-L1 axis binding antagonist and the individual's responsiveness to treatment with a therapy that does not contain a PD-L1 axis binding antagonist, above the reference immune score expression level, wherein the individual's responsiveness to treatment with a PD-L1 axis binding antagonist is significantly improved relative to the individual's responsiveness to treatment with a therapy that does not contain a PD-L1 axis binding antagonist. In some cases, the therapy without the PD-L1 axis binding antagonist comprises an anti-tumor agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, or a combination thereof. In some cases, the therapy without the PD-L1 axis binding antagonist comprises a chemotherapeutic agent. In some cases, the chemotherapeutic agent is docetaxel. In some cases, responsiveness to treatment comprises a prolongation of OS, a prolongation of PFS, or an increase in BCOR. In some cases, responsiveness to treatment includes an extension of Overall Survival (OS). In some cases, the reference immune score expression level is the median of the expression levels of each of the one or more genes in the reference population. In some cases, the median expression level is the median of the mean Z scores for the expression levels of each of the one or more genes in the reference population.
For example, provided herein is a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising: (a) Determining in a sample from the individual the expression level of one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, or 14) of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5, wherein determining the immune expression level of the one or more genes in the sample is greater than a reference immune score expression level for the one or more genes identifies the individual as likely to comprise treatment with a PD-L1 axis binding antagonist, wherein the benefit comprises a prolongation of the individual's OS as compared to treatment without a PD-L1 axis binding antagonist; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In another example, provided herein is a method of treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have an immune expression score for one or more of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, or 14) in a sample from the individual that is higher than a reference immune score expression level for the one or more genes, the method comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) wherein in the event the immune score expression level of the one or more genes is greater than the reference immune score expression level of the one or more genes, identifying the individual as an individual who is likely to benefit from treatment comprising the PD-L1 axis binding antagonist, wherein the benefit comprises a prolongation of OS in the individual as compared to treatment without the PD-L1 axis binding antagonist.
In yet another example, provided herein is a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for use in a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising: (a) Determining in a sample from the individual the expression level of one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, or 14) of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5, wherein determining the immune expression level of the one or more genes in the sample is greater than a reference immune score expression level for the one or more genes identifies the individual as an individual likely to comprise treatment with a PD-L1 axis binding antagonist, wherein the benefit comprises a prolongation of OS in the individual as compared to treatment without the PD-L1 axis binding antagonist; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another example, provided herein is a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have one or more of the genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, or 13) in a sample from the individual as having an immune response to a high level of immune expression of the gene expression, wherein the individual comprises a reference level of the immune-L expression of the immune antagonist that would benefit from treatment or a reference level of the individual.
In yet another example, provided herein is use of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for the manufacture of a medicament for use in a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) comprising: (a) Determining in a sample from the individual the expression level of one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, or 14) of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5, wherein determining the immune expression level of the one or more genes in the sample is greater than a reference immune score expression level for the one or more genes identifies the individual as an individual likely to comprise treatment with a PD-L1 axis binding antagonist, wherein the benefit comprises a prolongation of OS in the individual as compared to treatment without the PD-L1 axis binding antagonist; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another example, also provided herein is the use of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as alemtuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for the manufacture of a medicament for treating a cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have one or more of the genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV 4-1-12, IGLC7, and IGLL5 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or IGLV 1-12) in a sample from the individual, wherein the individual has an expression of the gene at a level that is higher than a reference level that would benefit from the use of the one or more of the PD-L1-1 expression of the PD-1, or 11 gene expression of the individual.
B.TLS
In some aspects, the methods provided herein can involve administering a PD-L1 axis binding antagonist to an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) based on the presence of TLS in a sample (e.g., tumor sample) from the individual.
For example, provided herein is a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising: (a) Determining the presence of TLS in a sample (e.g., a tumor sample) from the individual; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In another example, provided herein is a method of treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have TLS present in a sample (e.g., a tumor sample) from the individual, the method comprising administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., altlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In yet another example, provided herein is a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for use in a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising: (a) Determining the presence of TLS in a sample (e.g., a tumor sample) from the individual; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another example, provided herein is a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as altlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for use in treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have TLS present in a sample (e.g., a tumor sample) from the individual.
In yet another example, provided herein is the use of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for the manufacture of a medicament for use in a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., NSCLC), renal cancer (e.g., rcu), and breast cancer (e.g., TNBC)) comprising: (a) Determining the presence of TLS in a sample (e.g., a tumor sample) from the individual; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another example, also provided herein is the use of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attritumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for the manufacture of a medicament for treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have TLS present in a sample (e.g., a tumor sample) from the individual.
Any suitable method can be used to determine the presence of TLS in a sample. For example, in some cases, the presence of TLS is determined by histological staining, IHC, immunofluorescence, or gene expression analysis.
Any suitable histological staining method may be used. For example, in some cases, histological staining includes H & E staining.
Any suitable IHC or immunofluorescence method may be used. In some cases, IHC or immunofluorescence includes detecting CD62L, L-selectin, CD40, or CD8, e.g., using antibodies (e.g., anti-CD 62L antibodies, anti-L-selectin antibodies, anti-CD 40 antibodies, and/or anti-CD 8 antibodies). In some cases, CD62L or L-selectin is detected using a MECA-79 antibody.
In some cases, the gene expression analysis comprises determining the expression level of a TLS gene signature in the sample. For example, gene expression analysis can involve determining the expression level of any of the TLS features disclosed herein (see, e.g., section II, section C, below). In some cases, a TLS gene signature comprises one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12) of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13. In some cases, the gene comprises two or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13.
In some cases, the sample may include one TLS. In other cases, a sample can include more than one TLS, e.g., 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 50, 60, 70, 80, 90, 100, or more TLS.
Any suitable sample may be used. In some cases, the sample is a tissue sample, a cell sample, a whole blood sample, a plasma sample, a serum sample, or a combination thereof. In some cases, the tissue sample is a tumor tissue sample. In some cases, the tumor sample is a tumor tissue sample. In some cases, the tumor tissue sample comprises tumor cells, tumor infiltrating immune cells, stromal cells, NAT cells, or a combination thereof. In some cases, the tumor tissue sample is an FFPE sample, an archived sample, a fresh sample, or a frozen sample. In some cases, the tumor tissue sample is an FFPE sample.
The cancer may be any suitable type of cancer. In some cases, the cancer is lung cancer, kidney cancer, bladder cancer, breast cancer, colorectal cancer, ovarian cancer, pancreatic cancer, stomach cancer, esophageal cancer, mesothelioma, melanoma, head and neck cancer, thyroid cancer, sarcoma, prostate cancer, glioblastoma, cervical cancer, thymus cancer, leukemia, lymphoma, myeloma, mycosis fungoides, merkel cell carcinoma, or a hematological malignancy. In some cases, the cancer is lung, kidney, bladder, or breast cancer. In some cases, the lung cancer is NSCLC. In some cases, the NSCLC is non-squamous NSCLC. In some cases, the NSCLC is squamous NSCLC.
In some cases, the benefit comprises a prolongation of OS in the individual, a prolongation of PFS in the individual, and/or an improvement in BCOR in the individual as compared to treatment without the PD-L1 axis binding antagonist. In some cases, the benefit comprises an extension of Overall Survival (OS) of the individual as compared to treatment without the PD-L1 axis binding antagonist.
C.TLS feature
In some aspects, the methods provided herein can involve administering a PD-L1 axis binding antagonist to an individual based on the expression level of one or more genes in the TLS signature. Any suitable TLS feature may be used. For example, the TLS signature can include one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12) genes listed in table 16.
For example, provided herein is a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising: (a) Determining an expression level of one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12) of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from the individual, wherein the determination of the immune score expression level of the one or more genes in the sample is higher than a reference immune score expression level of the one or more genes; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In another example, provided herein is a method of treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have an immune score expression level of one or more of genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12) in a sample from the individual that is higher than a reference immune score expression level of the one or more genes, the method comprising administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., attritrin bead) or a PD-1 binding antagonist (e.g., anti-PD 1 antibody)).
In yet another example, provided herein is a PD-L1 axis binding antagonist for use in a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising: (a) Determining an expression level of one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12) of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from the individual, wherein the determination of the immune score expression level of the one or more genes in the sample is higher than a reference immune score expression level of the one or more genes; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In another example, provided herein is a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as altlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for use in treating a cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have one or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12) in a sample from the individual at an immune score level that is higher than a reference immune score level for the one or more of the one or more genes.
In another example, provided herein is the use of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for the manufacture of a medicament for use in a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) comprising: (a) Determining an expression level of one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12) of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from the individual, wherein determining an immune score expression level of the one or more genes in the sample is higher than a reference immune score expression level of the one or more genes; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another example, also provided herein is the use of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attritumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for the manufacture of a medicament for treating a cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have one or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12) in a sample from the individual at an immune expression level that is greater than a reference immune expression level for the one or more genes.
Any suitable immuno-score reference expression level can be used. In some cases, the immune score reference expression level is an immune score expression level of one or more genes in the reference population. In some cases, the reference population is a population of individuals with cancer. In some cases, the population of individuals includes a first subset of individuals who have received treatment with a PD-L1 axis binding antagonist and a second subset of individuals who have received treatment with a therapy that does not contain a PD-L1 axis binding antagonist. In some cases, the reference immune score expression level visibly differentiates each of the first subset of individuals from the second subset of individuals based on a significant difference between the individual's responsiveness to treatment with a PD-L1 axis binding antagonist and the individual's responsiveness to treatment with a therapy that does not contain a PD-L1 axis binding antagonist, above the reference immune score expression level, wherein the individual's responsiveness to treatment with a PD-L1 axis binding antagonist is significantly improved relative to the individual's responsiveness to treatment with a therapy that does not contain a PD-L1 axis binding antagonist. In some cases, the therapy without the PD-L1 axis binding antagonist comprises an anti-neoplastic agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, or a combination thereof. In some cases, the therapy without the PD-L1 axis binding antagonist comprises a chemotherapeutic agent. In some cases, the chemotherapeutic agent is docetaxel. In some cases, responsiveness to treatment comprises prolongation of OS, prolongation of PFS, or an increase in BCOR. In some cases, responsiveness to treatment includes an extension of Overall Survival (OS). In some cases, the reference immune score expression level is the median of the expression levels of each of the one or more genes in the reference population. In some cases, the median expression level is the median of the mean Z scores for the expression levels of each of the one or more genes in the reference population.
In some cases, the gene comprises two or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13.
For example, provided herein is a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising: (a) Determining an expression level of two or more (e.g., 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12) of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from the individual, wherein determining an immune score expression level of the two or more genes in the sample is higher than a reference immune score expression level of the two or more genes; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In another example, provided herein is a method of treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have an immune score expression level of two or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 (e.g., 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12) in a sample from the individual that is higher than a reference immune score expression level of the two or more genes, the method comprising administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attritrin monoclonal antibody) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In yet another example, provided herein is a PD-L1 axis binding antagonist for use in a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), renal cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising: (a) Determining an expression level of two or more (e.g., 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12) of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from the individual, wherein determining an immune score expression level of the two or more genes in the sample is higher than a reference immune score expression level of the two or more genes; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In another example, provided herein is a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attrituximab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for use in treating a cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have an immune score expression level of two or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 (e.g., 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12) in a sample from the individual that is higher than a reference immune score expression level of the two or more genes.
In another example, provided herein is the use of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for the manufacture of a medicament for use in a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) comprising: (a) Determining an expression level of two or more (e.g., 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12) of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from the individual, wherein determining an immune score expression level of the two or more genes in the sample is higher than a reference immune score expression level of the two or more genes; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another example, also provided herein is the use of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attritumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for the manufacture of a medicament for treating a cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have an immune score expression level of two or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 (e.g., 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12) in a sample from the individual that is higher than a reference immune expression level of the two or more genes.
In some cases, the reference immune score expression level is an immune score expression level of two or more genes in a reference population. In some cases, the reference population is a population of individuals with cancer. In some cases, the population of individuals includes a first subset of individuals who have received treatment with a PD-L1 axis binding antagonist and a second subset of individuals who have received treatment with a therapy that does not contain a PD-L1 axis binding antagonist. In some cases, the reference immune score expression level visibly differentiates each of the first subset of individuals from the second subset of individuals based on a significant difference between the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist and the responsiveness of the individual to treatment with the therapy without the PD-L1 axis binding antagonist above the reference expression level, wherein the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist is significantly improved relative to the responsiveness of the individual to treatment with the therapy without the PD-L1 axis binding antagonist. In some cases, the therapy without the PD-L1 axis binding antagonist comprises an anti-neoplastic agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, or a combination thereof. In some cases, the therapy without the PD-L1 axis binding antagonist comprises a chemotherapeutic agent. In some cases, the chemotherapeutic agent is docetaxel. In some cases, responsiveness to treatment comprises prolongation of OS, prolongation of PFS, or an increase in BCOR. In some cases, responsiveness to treatment includes an extension of Overall Survival (OS). In some cases, the reference immune score expression level is the median of the expression levels of each of the two or more genes in the reference population. In some cases, the median expression level is the median of the mean Z scores for the expression levels of each of the two or more genes in the reference population.
In some cases, the gene comprises three or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13. In some cases, the gene comprises four or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13. In some cases, the gene comprises five or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13. In some cases, the gene comprises six or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13. In some cases, the gene comprises seven or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13. In some cases, the gene comprises eight or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13. In some cases, the gene comprises nine or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13. In some cases, the gene comprises ten or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13. In some cases, the gene comprises eleven or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13.
Any combination of TLS signature genes can be identified, for example, as any combination of two genes selected from: CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13; any combination of three genes selected from: CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13; any combination of four genes selected from: CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13; any combination of five genes selected from: CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13; any combination of six genes selected from: CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13; any combination of seven genes selected from: CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13; any combination of eight genes selected from: CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13; any combination of nine genes selected from: CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13; any combination of ten genes selected from: CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13; any combination of eleven genes selected from: CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13; or any combination of eleven genes selected from: CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11 and CXCL13.
In some cases, the gene comprises CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13.
In some cases, the expression level is a nucleic acid expression level. For example, in some cases, the nucleic acid expression level is an mRNA expression level. mRNA expression levels can be determined using any suitable method (e.g., any method disclosed herein). In some cases, mRNA expression levels are determined by RNA-seq, RT-qPCR, multiplex qPCR or RT-qPCR, microarray analysis, SAGE, massARRAY technology, FISH, or combinations thereof. In some cases, mRNA expression levels are detected using RNA-seq.
In other cases, the expression level is a protein expression level. Protein expression levels can be determined using any suitable method (e.g., any of the methods disclosed herein). In some cases, protein expression levels are determined by IHC, immunofluorescence, mass spectrometry, flow cytometry, and western blotting, or combinations thereof.
Any suitable sample may be used. In some cases, the sample is a tissue sample, a cell sample, a whole blood sample, a plasma sample, a serum sample, or a combination thereof. In some cases, the tissue sample is a tumor tissue sample. In some cases, the tumor sample is a tumor tissue sample. In some cases, the tumor tissue sample comprises tumor cells, tumor infiltrating immune cells, stromal cells, NAT cells, or a combination thereof. In some cases, the tumor tissue sample is an FFPE sample, an archived sample, a fresh sample, or a frozen sample. In some cases, the tumor tissue sample is an FFPE sample.
The cancer may be any suitable type of cancer. In some cases, the cancer is lung cancer, kidney cancer, bladder cancer, breast cancer, colorectal cancer, ovarian cancer, pancreatic cancer, stomach cancer, esophageal cancer, mesothelioma, melanoma, head and neck cancer, thyroid cancer, sarcoma, prostate cancer, glioblastoma, cervical cancer, thymus cancer, leukemia, lymphoma, myeloma, mycosis fungoides, merkel cell carcinoma, or a hematological malignancy. In some cases, the cancer is lung, kidney, bladder, or breast cancer. In some cases, the lung cancer is NSCLC. In some cases, the NSCLC is non-squamous NSCLC. In some cases, the NSCLC is squamous NSCLC.
In some cases, the benefit comprises a prolongation of OS in the individual, a prolongation of PFS in the individual, and/or an improvement in BCOR in the individual as compared to treatment without the PD-L1 axis binding antagonist. In some cases, the benefit includes an extension of the Overall Survival (OS) of the individual as compared to treatment without the PD-L1 axis binding antagonist.
B cell number and clonally expanded B cells
In some aspects, the methods provided herein can involve administering a PD-L1 axis binding antagonist to an individual based on the presence and/or number of B cells in a sample from the individual. In some aspects, the methods provided herein can involve determining the presence and/or number of clonally expanded B cells in a sample from an individual.
For example, provided herein is a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising: (a) Determining the number of B cells in a tumor sample from the individual; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In another example, provided herein is a method of treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have a number of B cells in a tumor sample from the individual that is greater than a reference number of B cells, the method comprising administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., altlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In yet another example, provided herein is a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for use in a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising: (a) Determining the number of B cells in a tumor sample from the individual; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another example, provided herein is a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as altlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody) for treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have a number of B cells in a tumor sample from the individual that is higher than a reference number of B cells.
In another example, provided herein is the use of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for the manufacture of a medicament for use in a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) comprising: (a) Determining the number of B cells in a tumor sample from the individual; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another example, also provided herein is the use of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentimab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for the manufacture of a medicament for treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have a number of B cells in a tumor sample from the individual that is higher than a reference number of B cells.
The presence and/or number of any suitable type of B cells can be determined. For example, in some cases, B cells include CD79+ B cells, igG + B cells, and/or plasma cells.
In some embodiments, the presence and/or number of clonally expanded B cells may be determined.
For example, provided herein is a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), renal cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising: (a) Determining that the individual has clonally expanded B cells in a tumor sample from the individual; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In another example, provided herein is a method of treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have clonally expanded B cells in a tumor sample from the individual, the method comprising administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., altlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In yet another example, provided herein is a PD-L1 axis binding antagonist for use in a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), renal cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising: (a) Determining that the individual has clonally expanded B cells in a tumor sample from the individual; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In another example, provided herein is a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as altlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody) for treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have clonally expanded B cells in a tumor sample from the individual.
In another example, provided herein is the use of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for the manufacture of a medicament for use in a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) comprising: (a) Determining that the individual has clonally expanded B cells in a tumor sample from the individual; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist.
In another example, also provided herein is the use of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for the manufacture of a medicament for treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have clonally expanded B cells in a tumor sample from the individual.
The clonally expanded B cells may be any type of B cell. For example, in some cases, the clonally expanded B cells are clonally expanded plasma cells.
Clonally expanded B cells may be detected by any suitable method. For example, in some cases, clonally expanded B cells are detected by measuring the diversity of B Cell Receptor (BCR) gene lineages in tumor samples. In some cases, where a Shannon Diversity Index (SDI) of a BCR gene lineage in a tumor sample from an individual is lower than a reference SDI, the individual is identified as an individual who is likely to benefit from treatment comprising a PD-L1 axis binding antagonist.
Any suitable sample may be used. In some cases, the sample is a tissue sample, a cell sample, a whole blood sample, a plasma sample, a serum sample, or a combination thereof. In some cases, the tissue sample is a tumor tissue sample. In some cases, the tumor sample is a tumor tissue sample. In some cases, the tumor tissue sample comprises tumor cells, tumor infiltrating immune cells, stromal cells, NAT cells, or a combination thereof. In some cases, the tumor tissue sample is an FFPE sample, an archived sample, a fresh sample, or a frozen sample. In some cases, the tumor tissue sample is an FFPE sample.
The cancer may be any suitable type of cancer. In some cases, the cancer is lung cancer, kidney cancer, bladder cancer, breast cancer, colorectal cancer, ovarian cancer, pancreatic cancer, stomach cancer, esophageal cancer, mesothelioma, melanoma, head and neck cancer, thyroid cancer, sarcoma, prostate cancer, glioblastoma, cervical cancer, thymus cancer, leukemia, lymphoma, myeloma, mycosis fungoides, merkel cell carcinoma, or a hematological malignancy. In some cases, the cancer is lung, kidney, bladder, or breast cancer. In some cases, the lung cancer is NSCLC. In some cases, the NSCLC is non-squamous NSCLC. In some cases, the NSCLC is squamous NSCLC.
In some cases, the benefit comprises a prolongation of OS in the individual, a prolongation of PFS in the individual, and/or an improvement in BCOR in the individual as compared to treatment without the PD-L1 axis binding antagonist. In some cases, the benefit includes an extension of the Overall Survival (OS) of the individual as compared to treatment without the PD-L1 axis binding antagonist.
E.T Effector characteristics
In some aspects, the methods provided herein can involve administering a PD-L1 axis binding antagonist to an individual based on the presence and/or expression level of one or more T effector feature genes. Any suitable T effector feature may be used. For example, the T effector characteristic may include one or more (e.g., 1, 2, 3, 4, 5, 6, 7, or 8) genes listed in table 17. In some cases, CD274 is further detected.
For example, provided herein is a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising: (a) Determining in a sample from the individual the expression levels of (i) one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, or 20) of the genes listed in table 1 and (ii) one or more (e.g., 1, 2, 3, 4, 5, 6, 7, or 8) of the genes CD8A, EOMES, GZMA, TBX21, IFNG, GZMB, CXCL9, and CXCL10, wherein the one or more genes listed in (i) table 1 and (ii) the genes CD8A, EOMES, GZMB a, TBX21, IFNG, GZMB, CXCL9, and CXCL10 in the sample are determined to have a high expression score in the immune score of the one or more genes listed in (i) table 1, the reference gene or genes CD 21, the reference gene score of (i, cxmes, CXCL9, ifg 2, 5, 6, 7, or 8); and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In yet another example, provided herein is a PD-L1 axis binding antagonist for use in a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), renal cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising: (a) Determining in a sample from the individual the expression levels of (i) one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, or 20) of the genes listed in table 1 and (ii) one or more (e.g., 1, 2, 3, 4, 5, 6, 7, or 8) of the genes CD8A, EOMES, GZMA, TBX21, IFNG, GZMB, CXCL9, and CXCL10, wherein the one or more genes listed in (i) table 1 and (ii) the genes CD8A, EOMES, GZMB a, TBX21, IFNG, GZMB, CXCL9, and CXCL10 in the sample are determined to have a high expression score in the immune score of the one or more genes listed in (i) table 1, the reference gene or genes CD 21, the reference gene score of (i, cxmes, CXCL9, ifg 2, 5, 6, 7, or 8); and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In yet another example, provided herein is the use of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for the manufacture of a medicament for use in a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., NSCLC), renal cancer (e.g., rcu), and breast cancer (e.g., TNBC)) comprising: (a) Determining in a sample from the subject the expression levels of (i) one or more of the genes listed in table 1 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19 or 20) and (ii) one or more of the genes CD8A, EOMES, GZMA, TBX21, IFNG, GZMB, CXCL9 and CXCL10 (e.g., 1, 2, 3, 4, 5, 6, 7 or 8), wherein the expression levels of (i) one or more of the genes listed in table 1 and (ii) the genes CD8A, EOMES, GZMB a, TBX21, IFNG, GZMB, CXCL9 and CXCL10 in the sample are determined to be higher than the expression levels of (i) one or more of the genes listed in table 1 and (ii) the immune score of the genes CD8A, cxme, CXCL 21, cxsa, CXCL9 and CD 10; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In another example, provided herein is a method of treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have in a sample from the individual one or more of (i) one or more of the genes listed in table 1 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, or 20) and (ii) one or more of the genes CD8A, EOMES, GZMA, TBX21, IFNG, gzm b, CXCL9, and CXCL10 (e.g., 1, 2, 3, 4, 5, 6, 7, or 8) (e.g., the level of immune expression of the antagonist is higher than the level of the anti-CXCL 1, e.g., anti-CD 1, 2, 3, 4, 5, 6, 7, or 8) antagonists listed in the individual (e.g., binding to the anti-CXCL 1, e.g., anti-CD 1, 2, 3, 4, or 1, e.g., binding to the anti-spg., anti-CD 1, or anti-CD 1) gene).
In another example, provided herein is a PD-L1 axis binding antagonist (e.g., PD-L1 binding antagonist (e.g., anti-PD-L1 antibody, e.g., attrituzumab) or PD-1 binding antagonist (e.g., anti-PD-1 antibody)) for use in treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have in a sample from the individual a high level of expression of one or more of (i) the genes listed in table 1 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, or 20) and (ii) one or more of (e.g., 5, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, or 20) of the genes listed in (ii) CD8A, EOMES, gcmxa, gcmx, gccxa, gcx 21, ifgcl, and (ifgcl) genes.
In another example, also provided herein is the use of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for the manufacture of a medicament for treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have in a sample from the individual (i) one or more of the genes listed in table 1 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, or 20) and (ii) one or more (e.g., 1, 2, 3, 4, 5, 6, 7, or 8) of the genes CD8A, EOMES, GZMA, TBX21, IFNG, GZMB, CXCL9, and CXCL10, is higher than the reference immune score expression level of (i) one or more of the genes listed in table 1 and (ii) one or more of the genes CD8A, EOMES, GZMA, TBX21, IFNG, GZMB, CXCL9, and CXCL 10.
In some cases, the reference immune score expression level is an immune score expression level of one or more of (i) one or more genes listed in table 1 and (ii) one or more of the genes CD8A, EOMES, GZMA, TBX21, IFNG, GZMB, CXCL9, and CXCL10 in the reference population. In some cases, the reference population is a population of individuals with cancer. In some cases, the population of individuals includes a first subset of individuals who have received treatment with a PD-L1 axis binding antagonist and a second subset of individuals who have received treatment with a therapy that does not contain a PD-L1 axis binding antagonist. In some cases, the reference immune score expression level clearly distinguishes each of the first subset of individuals from the second subset of individuals based on a significant difference between the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist and the responsiveness of the individual to treatment with the therapy that does not contain the PD-L1 axis binding antagonist above the reference expression level, where the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist is significantly improved relative to the responsiveness of the individual to treatment with the therapy that does not contain the PD-L1 axis binding antagonist. In some cases, the therapy without the PD-L1 axis binding antagonist comprises an anti-neoplastic agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, or a combination thereof. In some cases, the therapy without the PD-L1 axis binding antagonist comprises a chemotherapeutic agent. In some cases, the chemotherapeutic agent is docetaxel. In some cases, responsiveness to treatment comprises prolongation of OS, prolongation of PFS, or an increase in BCOR. In some cases, responsiveness to treatment includes an extension of Overall Survival (OS). In some cases, the reference immune score expression level is the median of the expression levels of each of the two or more genes in the reference population. In some cases, the median expression level is the median of the average Z-scores for the expression levels of each of (i) the one or more genes listed in table 1 and (ii) the genes CD8A, EOMES, GZMA, TBX21, IFNG, GZMB, CXCL9, and CXCL10 in the reference population.
For example, provided herein is a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising: (a) Determining in a sample from the individual the expression levels of (i) one or more of the B cell characteristic genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ and MZB1 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 or 11) and (ii) one or more of the T effector characteristic genes CD8A, EOMES, GZMA, TBX21, IFNG, GZMB, CXCL9 and CXCL10 (e.g., 1, 2, 3, 4, 5, 6, 7 or 8), wherein the determination of the immune expression levels of (i) the one or more B cell characteristic genes and (ii) the one or more T effector characteristic genes in the sample is greater than the immune score of (i) the one or more B cell characteristic genes and (ii) the one or more T effector characteristic genes and the reference expression level of (i) the one or more T effector characteristic genes; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In another example, provided herein is a method of treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have in a sample from the individual one or more of (i) the B cell signature genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, rbzpj, and MZB1 (e.g., one or more of 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) and (ii) the T effector signature genes CD8A, mes, ga, TBX21, IFNG, GZMB, CXCL9, and CXCL10 (e.g., 1, 2, 3, 4, 5, 6, 7, or 8) is higher than a reference immune score expression level of (i) the one or more B cell signature genes and (ii) the one or more T effector signature genes, the method comprising administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as astuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In yet another example, provided herein is a PD-L1 axis binding antagonist for use in a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising: (a) Determining in a sample from the individual the expression levels of (i) one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) of B cell characteristic genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 and (ii) one or more (e.g., 1, 2, 3, 4, 5, 6, 7, or 8) T effector characteristic genes CD8A, EOMES, GZMA, TBX21, ifb, GZMB, CXCL9, and CXCL10, wherein the determination of the expression levels of (i) the one or more B cell characteristic genes and (ii) the one or more T effector characteristic genes in the sample is greater than the immune score of (i) the one or more B cell characteristic genes and (ii) the one or more T effector characteristic genes is greater than the immune score of (i) of the one or more B cell characteristic genes and (ii) the immune effector characteristic genes; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In another example, provided herein is a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for use in treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have in a sample from the individual one or more of (i) B cell signature genes CD79A, CD19, BANK1, jcain, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) and (ii) one or more (e.g., 1, 2, 3, 4, 5, 6, 7, or 8) of the T effector signature genes CD8A, EOMES, GZMA, TBX21, IFNG, GZMB, CXCL9, and CXCL10 are higher than the reference immune score expression level of (i) the one or more B cell signature genes and (ii) the one or more T effector signature genes.
In yet another example, provided herein is the use of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for the manufacture of a medicament for use in a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., NSCLC), renal cancer (e.g., rcu), and breast cancer (e.g., TNBC)) comprising: (a) Determining in a sample from the individual the expression levels of (i) one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) of B cell characteristic genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 and (ii) one or more (e.g., 1, 2, 3, 4, 5, 6, 7, or 8) T effector characteristic genes CD8A, EOMES, GZMA, TBX21, ifb, GZMB, CXCL9, and CXCL10, wherein the determination of the expression levels of (i) the one or more B cell characteristic genes and (ii) the one or more T effector characteristic genes in the sample is greater than the immune score of (i) the one or more B cell characteristic genes and (ii) the one or more T effector characteristic genes is greater than the immune score of (i) of the one or more B cell characteristic genes and (ii) the immune effector characteristic genes; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In another example, also provided herein is the use of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for the manufacture of a medicament for treating a cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have in a sample from the individual one or more of (i) B cell signature genes CD79A, CD19, BANK1, jcha, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) and (ii) one or more (e.g., 1, 2, 3, 4, 5, 6, 7, or 8) of the T effector characteristic genes CD8A, EOMES, GZMA, TBX21, IFNG, GZMB, CXCL9, and CXCL10, is higher than the reference immune score expression level of (i) the one or more B cell characteristic genes and (ii) the one or more T effector characteristic genes.
In some cases, the reference immune score expression level is an immune score expression level of (i) the one or more B cell signature genes and (ii) the one or more T effector signature genes in the reference population. In some cases, the reference population is a population of individuals with cancer. In some cases, the population of individuals includes a first subset of individuals who have received treatment with a PD-L1 axis binding antagonist and a second subset of individuals who have received treatment with a therapy that does not contain a PD-L1 axis binding antagonist. In some cases, the reference immune score expression level clearly distinguishes each of the first subset of individuals from the second subset of individuals based on a significant difference between the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist and the responsiveness of the individual to treatment with the therapy that does not contain the PD-L1 axis binding antagonist above the reference expression level, where the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist is significantly improved relative to the responsiveness of the individual to treatment with the therapy that does not contain the PD-L1 axis binding antagonist. In some cases, the therapy without the PD-L1 axis binding antagonist comprises an anti-tumor agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, or a combination thereof. In some cases, the therapy without the PD-L1 axis binding antagonist comprises a chemotherapeutic agent. In some cases, the chemotherapeutic agent is docetaxel. In some cases, responsiveness to treatment comprises a prolongation of OS, a prolongation of PFS, or an increase in BCOR. In some cases, responsiveness to treatment includes an extension of Overall Survival (OS). In some cases, the reference immune score expression level is the median of the expression levels of each of the two or more genes in the reference population. In some cases, the median expression level is the median of the mean Z scores for the expression levels of each of (i) the one or more B cell signature genes and (ii) the one or more T effector signature genes in the reference population.
In another example, provided herein is a method of treating cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have in a sample from the individual one or more of (i) the TLS signature genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 (e.g., one or more of 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12) and (ii) the T effector signature genes CD8A, mes, ga, TBX21, IFNG, GZMB, CXCL9, and CXCL10 (e.g., 1, 2, 3, 4, 5, 6, 7, or 8) is higher than a reference immune score expression level of (i) the one or more TLS signature genes and (ii) the one or more T effector signature genes, the method comprising administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attritumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In yet another example, provided herein is a PD-L1 axis binding antagonist for use in a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)), the method comprising: (a) Determining in a sample from the individual the expression levels of (i) one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12) of the TLS signature genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 and (ii) one or more (e.g., 1, 2, 3, 4, 5, 6, 7, or 8) of the T effector signature genes CD8A, EOMES, GZMA, TBX21, ifb, GZMB, CXCL9, and CXCL10, wherein the immune expression levels of (i) the one or more TLS signature genes and (ii) the one or more T effector signature genes in the sample are determined to be higher than the immune expression level of (i) the one or more TLS signature genes and (ii) of the one or more T effector signature genes; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In another example, provided herein is a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as altlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for use in treating a cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have in a sample from the individual one or more of (i) the TLS signature genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12) and (ii) one or more (e.g., 1, 2, 3, 4, 5, 6, 7, or 8) of the T effector signature genes CD8A, EOMES, GZMA, TBX21, IFNG, GZMB, CXCL9, and CXCL10 are higher than the reference immune score expression level of (i) the one or more TLS signature genes and (ii) the one or more T effector signature genes.
In yet another example, provided herein is use of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for the manufacture of a medicament for use in a method of treating an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) comprising: (a) Determining in a sample from the individual the expression level of (i) one or more of the TLS signature genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11 and CXCL13 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 or 12) and (ii) one or more of the T effector signature genes CD8A, EOMES, GZMA, TBX21, IFNG, GZMB, CXCL9 and CXCL10 (e.g., 1, 2, 3, 4, 5, 6, 7 or 8), wherein the immune expression level of (i) the one or more TLS signature genes and (ii) the one or more T effector signature genes in the sample is determined to be higher than the immune expression level of (i) the one or more TLS signature genes and (ii) the one or more T effector signature genes and the reference expression score of (i) or more TLS signature genes; and (b) administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In another example, also provided herein is the use of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as astuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) for the manufacture of a medicament for treating a cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) in an individual, wherein the individual has been determined to have in a sample from the individual (i) one or more of TLS signature genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12) and (ii) T response signature genes expressed at a, eoa, 5, 7, 8, 9, 10, 11, or 12, or 5, 7, or 8, e.g., more of the immune signature genes expressed at a high level (e.g., at one or more of the reference genes.
In some cases, the reference immune score expression level is the immune score expression level of (i) the one or more TLS signature genes and (ii) the one or more T effector signature genes in the reference population. In some cases, the reference population is a population of individuals with cancer. In some cases, the population of individuals includes a first subset of individuals who have received treatment with a PD-L1 axis binding antagonist and a second subset of individuals who have received treatment with a therapy that does not contain a PD-L1 axis binding antagonist. In some cases, the reference immune score expression level visibly differentiates each of the first subset of individuals from the second subset of individuals based on a significant difference between the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist and the responsiveness of the individual to treatment with the therapy without the PD-L1 axis binding antagonist above the reference expression level, wherein the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist is significantly improved relative to the responsiveness of the individual to treatment with the therapy without the PD-L1 axis binding antagonist. In some cases, the therapy without the PD-L1 axis binding antagonist comprises an anti-tumor agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, or a combination thereof. In some cases, the therapy without the PD-L1 axis binding antagonist comprises a chemotherapeutic agent. In some cases, the chemotherapeutic agent is docetaxel. In some cases, responsiveness to treatment comprises prolongation of OS, prolongation of PFS, or an increase in BCOR. In some cases, responsiveness to treatment includes an extension of Overall Survival (OS). In some cases, the reference immune score expression level is the median of the expression levels of each of the two or more genes in the reference population. In some cases, the median expression level is the median of the mean Z scores for the expression levels of each of (i) the one or more TLS signature genes and (ii) the one or more T effector signature genes in the reference population.
In some examples of any of the foregoing methods, the presence and/or level of expression of CD274 is further determined.
In any of the methods described herein, the method can further comprise determining the expression level of CD79A, CD274, and the expression level of one or more (e.g., 1, 2, 3, 4, 5, 6, 7, or 8) of the T effector feature genes CD8A, EOMES, GZMA, TBX21, IFNG, GZMB, CXCL9, and CXCL 10.
F. Administration of
PD-L1 axis binding antagonists (e.g., PD-L1 binding antagonists (e.g., anti-PD-L1 antibodies, such as attrituximab) or PD-1 binding antagonists (e.g., anti-PD-1 antibodies)) or compositions thereof and/or any additional therapeutic agents for use in the methods, uses, assays, and kits described herein may be formulated for administration or administered by any suitable method, including, for example: intravenous, intramuscular, subcutaneous, intradermal, transdermal, intraarterial, intraperitoneal, intralesional, intracranial, intraarticular, intraprostatic, intrapleural, intratracheal, intrathecal, intranasal, intravaginal, intrarectal, topical, intratumoral, intraperitoneal, subconjunctival, intracapsular, mucosal, intrapericardial, intraumbilical, intraocular, intraorbital, oral, topical, transdermal, intravitreal (e.g., by intravitreal injection), by eye drop, by inhalation, by injection, by infusion, by continuous infusion, by direct bathing of target cells by local infusion, by catheter, by lavage, by cream, or in a lipid composition. The compositions used in the methods described herein may also be administered systemically or locally. The method of administration may vary depending on a variety of factors (e.g., the compound or composition to be administered and the severity of the condition, disease or disease to be treated). In some cases, the PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., altlizumab) is administered intravenously, intramuscularly, subcutaneously, topically, orally, transdermally, intraperitoneally, intraorbitally, by implantation, by inhalation, intrathecally, intraventricularly, or intranasally. Administration may be by any suitable route, for example by injection, such as intravenous or subcutaneous injection, depending in part on whether administration is transient or chronic. Various dosing schedules are contemplated herein, including but not limited to single or multiple administrations at various time points, bolus administrations, and pulsed infusions.
The PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atelizumab) and any additional therapeutic agents can be formulated, dosed, and administered in a manner consistent with good medical practice. Factors to be considered in this context include the particular condition being treated, the particular mammal being treated, the clinical condition of the individual patient, the cause of the condition, the site of delivery of the agent, the method of administration, the timing of administration, and other factors known to the practitioner. PD-L1 axis binding antagonists (e.g., PD-L1 binding antagonists, e.g., anti-PD-L1 antibodies, e.g., atelizumab) are formulated and/or administered without, but optionally simultaneously with, one or more drugs currently used to prevent or treat the disorder in question. The effective amount of such other drugs depends on the amount of PD-L1 axis binding antagonist (e.g., PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atlizumab) present in the formulation, the type of disorder or treatment, and other factors described above. These are generally used at the same dosages and routes of administration as described herein, or at about 1% to 99% of the dosages described herein, or at any dosage and by any route empirically/clinically determined to be appropriate.
For the prevention or treatment of cancer (e.g., lung cancer (NSCLC), bladder cancer (UC), kidney cancer (RCC), or breast cancer (TNBC)), the appropriate dosage of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., attritumab) described herein (when used alone or in combination with one or more additional therapeutic agents) will depend on the type of disease to be treated, the severity and course of the disease, the PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., attritumab, administered for either prophylactic or therapeutic purposes, previous treatment, the clinical history of the patient, and the amount of the PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., attritumab) or a PD-1 binding antagonist (e.g., anti-PD-1 antibody)), and the discretion of the attending physician, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., attritumab) is suitably administered to the patient at one time or in a series of treatments. Such that the patient receives about two to about twenty, or, for example, about six doses of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attritumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody))). An initial higher loading dose may be administered followed by one or more lower doses. However, other dosage regimens may be useful. The progress of this therapy is readily monitored by conventional techniques and assays.
In some cases, an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) may be between about 60mg to about 5000mg (e.g., between about 60mg to about 4500mg, between about 60mg to about 4000mg, between about 60mg to about 3500mg, between about 60mg to about 3000mg, between about 60mg to about 2500mg, between about 650mg to about 2000mg, between about 60mg to about 1500mg, between about 100mg to about 1500mg, between about 300mg to about 1500mg, between about 500mg to about 1500mg, between about 700mg to about 1500mg, between about 1000mg to about 1000mg, between about 1000mg to about 1400mg, between about 1100mg to about 1300mg, between about 1150mg to about 1250mg, between about 5mg to about 1500mg, between about 1250mg to about 1200mg, or between about 1200.1200 mg ± 2mg, about 1200mg, or about 1200.1200 mg ± 0.1200 mg, e.g. ± 1mg ± 0 mg. In some cases, the method comprises administering to the individual about 1200mg (e.g., a fixed dose of about 1200mg or about 15 mg/kg) of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In some cases, the amount of PD-L1 axis binding antagonist (e.g., PD-L1 binding antagonist (e.g., anti-PD-L1 antibody, e.g., attrituximab) or PD-1 binding antagonist (e.g., anti-PD-1 antibody)) administered to an individual (e.g., a human) can be in the range of 0.01mg/kg body weight of the individual to about 50mg/kg body weight of the individual (e.g., between about 0.01mg/kg and about 45mg/kg, between about 0.01mg/kg and about 40mg/kg, between about 0.01mg/kg and about 35mg/kg, between about 0.01mg/kg and about 30mg/kg, between about 0.1mg/kg and about 30mg/kg, between about 1mg/kg and about 30mg/kg, between about 2mg/kg and about 30mg/kg, between about 5mg/kg and about 25mg/kg, between about 5mg/kg and about 20mg/kg, between about 10mg/kg and about 20mg/kg, or between about 12mg/kg and about 18mg/kg, such as about 15mg/kg + -2 mg/kg, about 15mg/kg + -1 mg/kg, about 15mg/kg + -0.5 mg/kg, about 15mg/kg + -0.2 mg/kg, or about 15 mg/0.1 mg/kg). In some cases, the method comprises administering to the individual about 15mg/kg of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attritumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) is administered intravenously to an individual (e.g., a human) at a dose of 1200mg every three weeks (q 3 w). The dose may be administered as a single dose or as multiple doses (e.g., 2, 3, 4, 5, 6, 7, or more than 7 doses), such as infusion.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered at a dose of about 840mg every two weeks, e.g., intravenously.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered at a dose of about 1200mg every three weeks, e.g., intravenously.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered at a dose of about 1680mg every four weeks, e.g., intravenously.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered intravenously (e.g., by infusion) over 60 minutes. In some cases, for example, if the first dose is tolerated, subsequent doses may be administered intravenously (e.g., by infusion) over a 30 minute period.
In some cases, atelizumab may be administered intravenously at a dose of about 840mg every two weeks.
In some cases, atelizumab may be administered intravenously at a dose of about 1200mg every three weeks.
In some cases, the atelizumab may be administered at a dose of about 1680mg every four weeks, e.g., intravenously.
In some cases, atelizumab may be administered intravenously at a dose of 840mg every two weeks.
In some cases, atelizumab may be administered intravenously at a dose of 1200mg every three weeks.
In some cases, the atelizumab may be administered at a dose of 1680mg every four weeks, e.g., intravenously.
The atezumab can be administered intravenously (e.g., by infusion) over 60 minutes. In some cases, for example, if tolerated for the first dose, subsequent doses of atuzumab may be administered intravenously (e.g., by infusion) over a period of 30 minutes.
The dose of antibody administered in the combination therapy can be reduced compared to monotherapy. The progress of the therapy can be readily monitored by conventional techniques. In one instance, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atlizumab) is administered to the individual as a monotherapy to treat cancer. In other instances, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atlizumab) is administered to the individual as a combination therapy (as described herein) to treat cancer.
G. Indications of
The methods and medicaments described herein can be used to treat a patient having cancer (e.g., lung cancer (e.g., NSCLC), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), or breast cancer (e.g., TNBC)) by administering to the individual an effective amount of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., attrituzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)). For example, the cancer can be lung cancer, kidney cancer, bladder cancer, breast cancer, colorectal cancer, ovarian cancer, pancreatic cancer, stomach cancer, esophageal cancer, mesothelioma, melanoma, head and neck cancer, thyroid cancer, sarcoma, prostate cancer, glioblastoma, cervical cancer, thymus cancer, leukemia, lymphoma, myeloma, mycosis fungoides, merkel cell carcinoma, or a hematological malignancy.
In some cases, the cancer is lung cancer. For example, the lung cancer may be non-small cell lung cancer (NSCLC), including but not limited to locally advanced or metastatic (e.g., stage IIIB, stage IV, or recurrence) NSCLC. In some cases, the lung cancer (e.g., NSCLC) is unresectable/inoperable lung cancer (e.g., NSCLC). In some cases, the lung cancer is lung cancer that has not received chemotherapy (e.g., metastatic NSCLC (mcnscc) that has not received chemotherapy). In some cases, the lung cancer is non-squamous lung cancer (e.g., non-squamous mslc). In some cases, the lung cancer is stage IV lung cancer (e.g., stage IV nsclc). In some cases, the lung cancer is recurrent lung cancer (e.g., recurrent mcnscc). In some cases, patients with lung cancer (e.g., NSCLC) have genomic alterations to EGFR or ALK. In some cases, lung cancer patients with EGFR or ALK genomic alterations develop disease progression/treatment intolerance when they receive one or more approved Tyrosine Kinase Inhibitors (TKIs).
In some cases, the cancer may be bladder cancer. For example, the bladder cancer may be Urothelial Cancer (UC), including, but not limited to, non-muscle invasive urothelial cancer, or metastatic urothelial cancer. In some cases, the urothelial cancer is metastatic urothelial cancer.
In some cases, the cancer may be renal cancer. For example, the renal cancer may be Renal Cell Carcinoma (RCC), including stage I RCC, stage II RCC, stage III RCC, stage IV RCC, or recurrent RCC.
In some cases, the cancer may be breast cancer. In some cases, the breast cancer may be a triple negative breast cancer. For example, the breast cancer can be triple negative breast cancer, estrogen receptor positive/HER 2 negative breast cancer, HER2 positive breast cancer, estrogen receptor negative breast cancer, progestin receptor positive breast cancer, or progestin receptor negative breast cancer.
In some cases, an individual having cancer (e.g., a cancer as described herein) has not been treated for the cancer. For example, an individual with cancer has not previously received a PD-L1 axis binding antagonist therapy (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as acilizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In some cases, an individual with cancer has been treated for cancer. In some cases, an individual with cancer has previously received treatment comprising a non-PD-L1 axis binding antagonist therapy (e.g., an anti-cancer therapy (e.g., a cytotoxic agent, a growth inhibitory agent, a radiation therapy, an anti-angiogenic agent, or a combination thereof)).
H. Combination therapy
In any of the methods described herein, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with an effective amount of one or more additional therapeutic agents. Suitable additional therapeutic agents include, for example, antineoplastic agents, chemotherapeutic agents, growth inhibitory agents, cytotoxic agents, radiation therapy, or combinations thereof.
In some cases, the method further comprises administering to the patient an effective amount of one or more additional therapeutic agents. In some cases, the additional therapeutic agent is selected from the group consisting of: cytotoxic agents, chemotherapeutic agents, growth inhibitory agents, radiotherapeutic agents, anti-angiogenic agents, and combinations thereof. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with a chemotherapy or chemotherapeutic agent. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with a radiotherapeutic agent. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with a targeted therapy or targeted therapeutic. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with an immunotherapy or immunotherapeutic agent (e.g., a monoclonal antibody). In some cases, the additional therapeutic agent is an agonist that targets an activating costimulatory molecule. In some cases, the additional therapeutic agent is an antagonist that targets an inhibitory co-stimulatory molecule.
Such combination therapies described above encompass both combined administration (where two or more therapeutic agents are included in the same or separate formulations) and separate administration, where administration of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atuzumab) described herein can be performed before, concurrently with, and/or after administration of an additional therapeutic agent or agents. In one instance, administration of the PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atuzumab) and administration of the additional therapeutic agent occur within about one month or within about one, two, or three weeks or within about one, two, three, four, five, or six days of each other.
Without wishing to be bound by theory, it is believed that enhancing T cell stimulation by promoting activation of co-stimulatory molecules or inhibiting negative co-stimulatory molecules can promote tumor cell death, thereby treating or delaying the progression of cancer. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with an agonist that targets an activating costimulatory molecule. In some cases, the activating co-stimulatory molecule may comprise CD40, CD226, CD28, OX40, GITR, CD137, CD27, HVEM, or CD127. In some cases, the agonist targeting the activating co-stimulatory molecule is an agonist antibody that binds to CD40, CD226, CD28, OX40, GITR, CD137, CD27, HVEM, or CD127. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with an antagonist that targets an inhibitory co-stimulatory molecule. In some cases, the inhibitory co-stimulatory molecule may comprise CTLA-4 (also known as CD 152), TIM-3, BTLA, VISTA, LAG-3, B7-H4, IDO, TIGIT, MICA/B, or arginase. In some cases, the antagonist that targets the inhibitory co-stimulatory molecule is an antagonist antibody that binds to CTLA-4, TIM-3, BTLA, VISTA, LAG-3, B7-H4, IDO, TIGIT, MICA/B, or arginase.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atelizumab) can be administered in combination with an antagonist (e.g., a blocking antibody) that targets CTLA-4 (also known as CD 152). In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atelizumab) can be conjugated to an ipilimumab (also referred to as MDX-010, MDX-101, or
Figure BDA0003990674580001901
) The administration is combined. In some cases, PD-L1 axis binding antagonists(e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., alemtuzumab) can be administered in combination with tremelimumab (also known as ticilimumab or CP-675,206). In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atelizumab) can be administered in combination with an antagonist (e.g., a blocking antibody) that targets B7-H3 (also referred to as CD 276). In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atuzumab) may be administered in combination with MGA 271. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., altlizumab) can be administered in combination with an antagonist that targets TGF- β (e.g., metelimumab (also known as CAT-192), fresolimumab (also known as GC 1008), or LY 2157299).
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., attrituximab) can be administered in combination with a therapy comprising adoptive transfer of T cells (e.g., cytotoxic T cells or CTLs) that express a Chimeric Antigen Receptor (CAR). In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atuzumab) may be administered in combination with a therapy comprising adoptive transfer of T cells comprising a dominant negative TGF β receptor (e.g., a dominant negative TGF β type II receptor). In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., attentizumab) can be administered in combination with a treatment comprising a HERCREEM regimen (see, e.g., clinical trials. Gov identifier NCT 00889954).
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atlizumab) can be administered in combination with an agonist (e.g., an activating antibody) that targets CD137 (also known as TNFRSF9, 4-1BB, or ILA). In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with urelumab (also referred to as BMS-663513). In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with an agonist (e.g., an activating antibody) that targets CD 40. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., altlizumab) can be administered in combination with CP-870893. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with an agonist (e.g., an activating antibody) that targets OX40 (also referred to as CD 134). In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., altuzumab) can be administered in combination with an anti-OX 40 antibody (e.g., agonOX). In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with an agonist (e.g., an activating antibody) that targets CD 27. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with CDX-1127. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atelizumab) can be administered in combination with an antagonist that targets indoleamine-2, 3-dioxygenase (IDO). In some cases, the IDO antagonist is 1-methyl-D-tryptophan (also referred to as 1-D-MT).
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with the antibody drug conjugate. In some cases, the antibody drug conjugate comprises mertansine or monomethyl auristatin E (MMAE). In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atelizumab) can be administered in combination with an anti-NaPi 2b antibody-MMAE conjugate (also referred to as DNIB0600A or RG 7599). In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atuzumab) can be combined with enritumumab (also referred to as T-DM1, ado-trastuzumab emtansine or
Figure BDA0003990674580001921
Gene tack) in combination. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., attentizumab) can be administered in combination with DMUC 5754A. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., attrituximab) can be administered in combination with an antibody drug conjugate that targets the endothelin B receptor (EDNBR) (e.g., a conjugate of an antibody that targets EDNBR and MMAE).
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with an anti-angiogenic agent. In some cases, sub>A PD-L1 axis binding antagonist (e.g., sub>A PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atelizumab) can be administered in combination with an antibody that targets VEGF (e.g., VEGF-Sub>A). In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atelizumab) can be combined with bevacizumab (also referred to as bevacizumab)
Figure BDA0003990674580001922
Gene tack) in combination. For example, attritumab may be administered in combination with bevacizumab. In other cases, atelizumab may be administered in combination with bevacizumab and one or more chemotherapeutic agents (e.g., carboplatin and/or paclitaxel). In certain instances, atelizumab may be administered in combination with bevacizumab, carboplatin, and paclitaxel. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., altlizumab) can be administered in combination with an antibody that targets angiopoietin 2 (also known as Ang 2). In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atlizumab) can be administered in combination with MEDI 3617.
A VEGF antagonist (e.g., bevacizumab) administered to a subject (e.g., a human) in combination with a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., altlizumab) may be in the range of 0.01mg/kg to about 50mg/kg of the subject's body weight (e.g., between about 0.01mg/kg to about 45mg/kg, between about 0.01mg/kg to about 40mg/kg, between about 0.01mg/kg to about 35mg/kg, between about 0.01mg/kg to about 30mg/kg, between about 0.1mg/kg to about 30mg/kg, between about 1mg/kg to about 30mg/kg, between about 2mg/kg to about 30mg/kg, between about 5mg/kg to about 25mg/kg, between about 5mg/kg to about 20mg/kg, between about 10mg/kg to about 20mg/kg, about 15mg/kg, such as about 15mg/kg, or about 0.15 mg/kg, about 0.1mg/kg to about 15 mg/kg). For example, in some cases, the method comprises administering to the individual about 1200mg of a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attritumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) in combination with about 15mg/kg of the individual's body weight of a VEGF antagonist (e.g., bevacizumab). The method may further comprise administering one or more chemotherapeutic agents, such as carboplatin and/or paclitaxel.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with an anti-neoplastic agent. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with a drug that targets CSF-1R (also referred to as M-CSFR or CD 115). In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atelizumab) can be administered in combination with an anti-CSF-1R (also referred to as IMC-CS 4). In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atelizumab) can be administered in combination with an interferon (e.g., interferon alpha or interferon gamma). In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., altlizumab) can be administered in combination with roscovitine-a (also known as recombinant interferon alpha-2 a). In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atuzumab) can be conjugated to GM-CSF (also Referred to as recombinant human granulocyte macrophage colony-stimulating factor, rhu GM-CSF, sargramostim or
Figure BDA0003990674580001941
) The administration is combined. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atelizumab) can be conjugated to IL-2 (also known as aldesleukin or alemtuzumab)
Figure BDA0003990674580001942
) The administration is combined. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with IL-12. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with an antibody that targets CD 20. In some cases, the CD 20-targeting antibody is obinutuzumab (also known as GA101 or GA 101)
Figure BDA0003990674580001943
) Or rituximab. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with an antibody that targets GITR. In some cases, the antibody targeting GITR is TRX518.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with a cancer vaccine. In some cases, the cancer vaccine is a peptide cancer vaccine, which in some cases is a personalized peptide vaccine. In some cases, the peptide Cancer vaccine is a multivalent long peptide, polypeptide, peptide mixture, hybrid peptide, or peptide-loaded dendritic cell vaccine (see, e.g., yamada et al, cancer sci.104:14-21, 2013). In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with an adjuvant. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., a Tezumab) can be combined with TLR agonists (e.g., poly-ICLC (also known as
Figure BDA0003990674580001944
) LPS, MPL or CpG ODN). In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atelizumab) can be administered in combination with Tumor Necrosis Factor (TNF) alpha (TNF-alpha). In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with IL-1. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with HMGB 1. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with an IL-10 antagonist. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with an IL-4 antagonist. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with an IL-13 antagonist. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atlizumab) can be administered in combination with an HVEM antagonist. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., altuzumab) can be administered in combination with an ICOS agonist, e.g., by administering ICOS-L or an agonistic antibody that targets ICOS. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., altlizumab) can be administered in combination with a CX3CL 1-targeted therapy. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atlizumab) can be administered in combination with a treatment that targets CXCL 9. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atelizumab) can be combined with Treatment targeting CXCL10 is administered in combination. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atlizumab) may be administered in combination with a therapy that targets CCL 5. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., altlizumab) can be administered in combination with an LFA-1 or ICAM1 agonist. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with a selectin agonist.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with a targeted therapy. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with an inhibitor of B-Raf. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atelizumab) can be combined with vemurafenib (also referred to as vemurafenib)
Figure BDA0003990674580001951
) The administration is combined. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., attentizumab) can be combined with dabrafenib (also known as dabrafenib)
Figure BDA0003990674580001952
) The administration is combined. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., attentizumab) can be combined with erlotinib (also known as erlotinib)
Figure BDA0003990674580001961
) The administration is combined. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., attentizumab) can be administered in combination with an inhibitor of MEK, such as MEK1 (also known as MAP2K 1) or MEK2 (also known as MAP2K 2). In some cases, PD-L1 axis binding antagonists(e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., astuzumab) can be administered in combination with cobicistinib (also known as GDC-0973 or XL-518). In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atelizumab) can be combined with trametinib (also referred to as tremelimumab)
Figure BDA0003990674580001962
) The administration is combined. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with an inhibitor of K-Ras. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with an inhibitor of c-Met. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with Onartuzumab (also known as MetMAb). In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with an inhibitor of Alk. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., altuzumab) can be administered in combination with AF802 (also known as CH5424802 or aletinib). In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atelizumab) can be administered in combination with a phosphatidylinositol 3-kinase (PI 3K). In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atlizumab) can be administered in combination with BKM 120. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atlizumab) can be administered in combination with Idelalisib (also known as GS-1101 or CAL-101). In some embodiments, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atelizumab) can be administered in combination with pirifolin (also known as KRX-0401). In some embodiments, the PD-L1 axis binding antagonist (e.g., PD-L1 binding) An antagonist, e.g., an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with an inhibitor of Akt. In some embodiments, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with MK 2206. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., attentizumab) can be administered in combination with GSK 690693. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atlizumab) can be administered in combination with GDC-0941. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., altuzumab) can be administered in combination with an inhibitor of mTOR. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atelizumab) can be administered in combination with sirolimus (also referred to as rapamycin). In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atelizumab) can be combined with temsirolimus (also referred to as CCI-779 or as
Figure BDA0003990674580001971
) The administration is combined. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., attrituximab) can be administered in combination with everolimus (also referred to as RAD 001). In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atlizumab) can be administered in combination with Ridaforolimus (also known as AP-23573, MK-8669, or Deforolimus). In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atlizumab) can be administered in combination with OSI-027. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., altlizumab) can be administered in combination with AZD 8055. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with INK 128.In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with a dual PI3K/mTOR inhibitor. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., altuzumab) can be administered in combination with XL 765. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atlizumab) can be administered in combination with GDC-0980. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atelizumab) may be administered in combination with BEZ235 (also referred to as NVP-BEZ 235). In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with BGT 226. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, e.g., an anti-PD-L1 antibody, e.g., atuzumab) may be administered in combination with GSK 2126458. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atlizumab) can be administered in combination with PF-04691502. In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist, such as an anti-PD-L1 antibody, e.g., atuzumab) can be administered in combination with PF-05212384 (also known as PKI-587).
(i) Combination therapy in clinical trials
A PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., attritumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered to an individual in combination with one or more additional therapeutic agents, wherein prior to or after treatment the individual has undergone diagnostic testing according to any of the diagnostic methods described herein and has been identified as an individual who may benefit from treatment with a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., attritumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)). As described further below, the additional therapeutic agent may have been tested or is being tested in a clinical trial for cancer therapy including attentizumab.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attrituzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with obinutuzumab and Polatuzumab vedotin (e.g., in the treatment of lymphoma (e.g., relapsed or refractory follicular lymphoma or diffuse large B-cell lymphoma), as described in clinical trial NCT 02729896.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attrituzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be combined with paclitaxel (e.g., albumin-bound paclitaxel (nab-paclitaxel))
Figure BDA0003990674580001981
) Co-administration, e.g., in the treatment of breast cancer (e.g., TNBC), as described in clinical trial NCT 02530489.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atelizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be conjugated to bevacizumab (also referred to as an anti-PD-1 antibody)
Figure BDA0003990674580001982
) In combination (e.g. in the treatment of locally advanced or metastatic tumours (e.g. in the treatment of breast, cervical, renal, gastric, ovarian or bladder cancer) as described in clinical trial NCT 01633970.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be combined with bevacizumab (also referred to as an anti-PD-1 antibody))
Figure BDA0003990674580001991
) And folinic acid/oxaliplatin/5-fluorouracil (FOLFOX) (e.g., in the treatment of locally advanced or metastatic tumors, e.g., in breast cancer, cervical cancer Renal, gastric, ovarian or bladder cancer) as described in clinical trial NCT 01633970.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attrituzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be combined with paclitaxel (e.g., albumin-bound paclitaxel (nab-paclitaxel))
Figure BDA0003990674580001992
) And carboplatin (e.g.,
Figure BDA0003990674580001993
) In combination (e.g. in the treatment of locally advanced or metastatic tumours, for example in the treatment of lung cancer (NSCLC), breast cancer, cervical cancer, renal cancer, gastric cancer, ovarian cancer or bladder cancer), as described in clinical trial NCT 01633970.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attrituzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be combined with paclitaxel (e.g., albumin-bound paclitaxel (nab-paclitaxel))
Figure BDA0003990674580001994
) In the treatment of locally advanced or metastatic tumors (e.g. in the treatment of lung cancer (NSCLC), breast cancer, cervical cancer, renal cancer, gastric cancer, ovarian cancer or bladder cancer), as described in clinical trial NCT 01633970.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be combined with pemetrexed (e.g.,
Figure BDA0003990674580001995
) And carboplatin (for example,
Figure BDA0003990674580001996
) Combined administration (e.g. in the local evening)In the treatment of stage or metastatic tumours, for example in the treatment of breast, cervical, renal, gastric, ovarian or bladder cancer), as described in clinical trial NCT 01633970.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be conjugated to an etoposide (e.g.,
Figure BDA0003990674580001997
) And carboplatin (for example,
Figure BDA0003990674580001998
) In combination administration (e.g., in the treatment of lung cancer (e.g., small Cell Lung Cancer (SCLC)) as described in clinical trial NCT 02748889.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attrituzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be combined with paclitaxel (e.g., albumin-bound paclitaxel (nab-paclitaxel))
Figure BDA0003990674580002001
) And carboplatin (for example,
Figure BDA0003990674580002002
) In combination (e.g. in the treatment of locally advanced or metastatic tumours, for example in the treatment of lung cancer (NSCLC)), as described in clinical trial NCT 02716038.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with an Epacadostat (e.g., INCB 024360) (e.g., in the treatment of lung cancer (e.g., NSCLC) or bladder cancer (e.g., urothelial cancer)), as described in clinical trial NCT 02298153.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attrituzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with radiation therapy and chemotherapy (e.g., carboplatin and/or paclitaxel), for example, in the treatment of lung cancer (e.g., NSCLC), as described in clinical trial NCT 02525757.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with veliparib (e.g., in the treatment of breast cancer (e.g., TNBC, BRCA1 gene mutation, BRCA2 gene mutation, estrogen receptor negative breast cancer, her2/Neu negative breast cancer, stage IIIA breast cancer, stage IIIB breast cancer, stage IIIC breast cancer, or stage IV breast cancer)), as described in clinical trial NCT 02849496.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as alemtuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be conjugated to alendronide (also referred to as an anti-PD-1 antibody)
Figure BDA0003990674580002003
) Combined administration (e.g., in the treatment of lung cancer (e.g., NSCLC)) as described in clinical trial NCT 02013219.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be conjugated to erlotinib (also referred to as erlotinib)
Figure BDA0003990674580002004
) Combined administration (e.g., in the treatment of lung cancer (e.g., NSCLC)) as described in clinical trial NCT 02013219.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., attrituximab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with MTIG7192A (e.g., in the treatment of advanced metastatic tumors), as described in clinical trial NCT 02794571.
In some cases, PD-L1 axis binding antagonismAn anti-agent (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., attrituximab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be conjugated to vemurafenib (also referred to as an anti-PD-1 antibody)
Figure BDA0003990674580002011
) In combination (e.g. in the treatment of skin cancer (e.g. malignant melanoma)) as described in clinical trial NCT 01656642.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be combined with vemurafenib (also referred to as an anti-PD-1 antibody))
Figure BDA0003990674580002012
) And cobicistinib (also known as cobicistinib)
Figure BDA0003990674580002013
) In combination (e.g. in the treatment of skin cancer (e.g. malignant melanoma)) as described in clinical trial NCT 01656642.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be combined with bevacizumab (also referred to as an anti-PD-1 antibody))
Figure BDA0003990674580002014
Gene tag company) in combination (e.g., in the treatment of ovarian, fallopian tube, or peritoneal carcinoma), as described in clinical trial NCT 0283907.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as altlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with obinutuzumab (e.g., in the treatment of lymphoma (e.g., lymphocytic lymphoma or relapsed refractory or Chronic Lymphocytic Leukemia (CLL)), as described in clinical trial NCT 02846623.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as altuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with carboplatin and pemetrexed (e.g., in the treatment of lung cancer (e.g., NSCLC)), as described in clinical trial NCT 02657434.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with cisplatin and pemetrexed (e.g., in the treatment of lung cancer (e.g., NSCLC)), as described in clinical trial NCT 02657434.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with Tazemetostat (e.g., in the treatment of a lymphoma (e.g., follicular lymphoma or diffuse large b-cell lymphoma)) as described in clinical trial NCT 20802242.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., altlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with obintuuzumab (e.g., in the treatment of lymphoma (e.g., follicular lymphoma or diffuse large b-cell lymphoma)), as described in clinical trial NCT 20802242.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as altlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with lenalidomide (e.g., in the treatment of multiple myeloma), as described in clinical trial NCT 02431208.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with daratuzumab (e.g., in the treatment of multiple myeloma), as described in clinical trial NCT 02431208.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with daratuzumab and lenalidomide (e.g., in the treatment of multiple myeloma), as described in clinical trial NCT 02431208.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as altuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with daratuzumab and pomalidomide (e.g., in the treatment of multiple myeloma), as described in clinical trial NCT 02431208.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atelizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be conjugated to bevacizumab (also referred to as an anti-PD-1 antibody)
Figure BDA0003990674580002032
Gene tack) in combination (e.g., in the treatment of renal cancer (e.g., renal cell carcinoma), as described in clinical trial NCT 02420821.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., altlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with stereotactic somatic radiation (e.g., in the treatment of lung cancer (e.g., NSCLC)), as described in clinical trial NCT 02400814.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attritumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with rociletinib (e.g., in the treatment of lung cancer (e.g., NSCLC)), as described in clinical trial NCT 02630186.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attritumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with GDC-0919 (e.g., in the treatment of a solid tumor (e.g., renal Cell Carcinoma (RCC), urothelial Cancer (UC), triple-negative breast cancer (TNBC), non-small cell lung cancer (NSCLC), melanoma, head and Neck Squamous Cell Carcinoma (HNSCC), gastric cancer, ovarian cancer, cervical cancer, endometrial cancer, or Merkel cell carcinoma), as described in clinical trial NCT 02471846.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., altuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with radium dichloride-223 (e.g., in the treatment of lung cancer, prostate cancer (e.g., castration resistant prostate cancer)), as described in clinical trial NCT 02814669.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with MOXR0916 (e.g., in the treatment of a solid tumor (e.g., a locally advanced or metastatic solid tumor)), as described in clinical trial NCT 02410512.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be combined with bevacizumab (also referred to as an anti-PD-1 antibody))
Figure BDA0003990674580002031
Gene tack) and MOXR0916 (e.g., in the treatment of solid tumors (e.g., locally advanced or metastatic solid tumors), as described in clinical trial NCT 02410512.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., altlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with azacitidine (e.g., in the treatment of a solid tumor (e.g., myelodysplastic syndrome)), as described in clinical trial NCT 02508870.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atebrine)Anti) or PD-1 binding antagonist (e.g., anti-PD-1 antibody) can be combined with paclitaxel (e.g., albumin-bound paclitaxel (nab-paclitaxel)
Figure BDA0003990674580002041
) Co-administration (e.g., in the treatment of breast cancer (e.g., TNBC)), as described in clinical trial NCT 02425891.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with lenalidomide and ouabituzumab (e.g., in the treatment of lymphoma), as described in clinical trial NCT 02631577.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be conjugated to an etoposide (e.g.,
Figure BDA0003990674580002042
) And carboplatin (for example,
Figure BDA0003990674580002043
) In combination (e.g., in the treatment of lung cancer (e.g., small Cell Lung Cancer (SCLC)), as described in clinical trial NCT 02763579.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as alemtuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with an ipilimumab (e.g., in the treatment of a locally advanced or metastatic solid tumor), as described in clinical trial NCT 02174172.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attrituximab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with interferon alpha-2 b (e.g., in the treatment of a locally advanced or metastatic solid tumor (e.g., NSCLC, melanoma, or RCC)) as described in clinical trial NCT 02174172.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with macro-fractionated image-guided radiotherapy (e.g., in the treatment of lung cancer (e.g., NSCLC)), as described in clinical trial NCT 02463994.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., astuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with CDX-1401 (e.g., in the treatment of lung cancer (e.g., NSCLC)), as described in clinical trial NCT 02495636.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., attrituzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with CDX-1401 (e.g., in the treatment of lung cancer (e.g., NSCLC)), as described in clinical trial NCT 02495636.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with trastuzumab and pertuzumab (e.g., in the treatment of breast cancer (e.g., her2 positive breast cancer)), as described in clinical trial NCT 05026915.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with enrmetuzumab (e.g., in the treatment of breast cancer (e.g., her2 positive breast cancer)), as described in clinical trial NCT 02605915.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with doxorubicin and cyclophosphamide (e.g., in the treatment of breast cancer (e.g., her2 positive breast cancer)), as described in clinical trial NCT 02605915.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., altuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with trastuzumab, pertuzumab, and docetaxel (e.g., in the treatment of breast cancer (e.g., her2 positive breast cancer)), as described in clinical trial NCT 02605915.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atelizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be conjugated to bevacizumab (also referred to as an anti-PD-1 antibody)
Figure BDA0003990674580002061
) In combination (e.g., in the treatment of renal cancer (e.g., advanced non-clear cell renal cancer)), as described in clinical trial NCT 02724878.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with CMB305 (e.g., in the treatment of a sarcoma (e.g., mucoid/round cell liposarcoma, synovial sarcoma, metastatic sarcoma, adult recurrent soft tissue sarcoma, locally advanced sarcoma, or liposarcoma), as described in clinical trial NCT 02609984.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., altlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with RO7009789 (e.g., in the treatment of a solid cancer (e.g., locally advanced and metastatic solid tumors), as described in clinical trial NCT 02304393.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be associated with bcg (also referred to as an anti-PD-1 antibody))
Figure BDA0003990674580002062
) In combination (e.g., in the treatment of bladder cancer (e.g., non-muscle invasive bladder cancer)) as described in clinical trial NCT 02792192.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., altlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with stereotactic physical radiotherapy (e.g., in the treatment of lung cancer (e.g., NSCLC)), as described in clinical trial NCT 02599454.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be combined with carboplatin and albumin-bound paclitaxel (also referred to as carboplatin and albumin-bound paclitaxel)
Figure BDA0003990674580002063
Co-administration) co-administration (e.g., in the treatment of breast cancer (e.g., breast invasive ductal carcinoma) as described in clinical trial NCT 02620280.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be combined with carboplatin, albumin-bound paclitaxel (also known as albumin-bound paclitaxel))
Figure BDA0003990674580002071
) And adjuvant chemotherapy (including AC or EC (doxorubicin or epirubicin and cyclophosphamide) or FEC (fluorouracil, epirubicin and cyclophosphamide)) in combination (e.g., in the treatment of breast cancer (e.g., breast invasive ductal carcinoma), as described in clinical trial NCT 02620280.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., altlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with gemcitabine and carboplatin or cisplatin (e.g., in the treatment of urothelial cancer), as described in clinical trial NCT 02807636.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., attrituximab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with paclitaxel and carboplatin (e.g., in the treatment of lung cancer (e.g., NSCLC, e.g., non-squamous NSCLC)), as described in clinical trial NCT 02366143.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., altlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with bevacizumab, paclitaxel, and carboplatin (e.g., in the treatment of lung cancer (e.g., NSCLC, e.g., non-squamous NSCLC)), as described in clinical trial NCT 02366143.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., attrituzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with cerglutuzumab (also referred to as RO 6895882) (e.g., in the treatment of locally advanced and/or metastatic solid tumors), as described in clinical trial NCT 02350673.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with bendamustine and ouabituzumab (e.g., in the treatment of lymphoma (e.g., diffuse large B-cell lymphoma or follicular lymphoma), as described in clinical trial NCT 02596971.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as altuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with bendamustine, cyclophosphamide, obinutuzumab, prednisone, and vincristine (e.g., in the treatment of lymphoma (e.g., diffuse large B-cell lymphoma or follicular lymphoma), as described in clinical trial NCT 02596971.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as alemtuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with cyclophosphamide, doxorubicin, obinutuzumab, prednisone, and vincristine (e.g., in the treatment of lymphoma (e.g., diffuse large B-cell lymphoma or follicular lymphoma), as described in clinical trial NCT 02596971.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attrituximab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with cyclophosphamide, doxorubicin, prednisone, vincristine and rituximab (e.g., in the treatment of lymphoma (e.g., diffuse large B-cell lymphoma or follicular lymphoma), as described in clinical trial NCT 02596971.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as alemtuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with RO6958688 (e.g., in the treatment of locally advanced and/or metastatic solid tumors (e.g., carcinoembryonic antigen (CEA) -positive solid tumors)), as described in clinical trial NCT 02650713.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with acetylsalicylic acid (e.g., in the treatment of ovarian cancer (e.g., ovarian tumor)), as described in clinical trial NCT 02659384.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with bevacizumab (e.g., in the treatment of ovarian cancer (e.g., ovarian tumor)), as described in clinical trial NCT 02659384.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attrituzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with vanucizumab (also known as RO 5520985) (e.g., in the treatment of locally advanced and/or metastatic solid tumors), as described in clinical trial NCT 01688206.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., altlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with carboplatin and an albumin-bound paclitaxel (e.g., in the treatment of lung cancer (e.g., non-squamous NSCLC), as described in clinical trial NCT 02367781.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be combined with bevacizumab (also referred to as an anti-PD-1 antibody))
Figure BDA0003990674580002091
) In combination (e.g., in the treatment of renal cancer (e.g., renal cell carcinoma)), as described in clinical trial NCT 01984242.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attentizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with cobicistinib (also referred to as GDC-0973) (e.g., in the treatment of locally advanced or metastatic solid tumors), as described in clinical trial NCT 01988896.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., altlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with RO5509554 (e.g., in the treatment of locally advanced solid tumors (e.g., locally advanced and/or metastatic triple negative breast cancer, ovarian cancer, bladder cancer, gastric cancer, or soft tissue sarcoma), as described in clinical trial NCT 02323191.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attrituzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with vallizumab (varlumab) (e.g., in the treatment of advanced cancer (e.g., melanoma, RCC, triple negative breast cancer, bladder cancer, head and neck cancer, or non-small cell lung cancer)), as used in clinical trial NCT 02543645.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., attrituximab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with cobitinib (e.g., in the treatment of colorectal cancer), as described in clinical trial NCT 02788279.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., altlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with cobicistinib (e.g., in the treatment of colorectal cancer), as described in clinical trial NCT 02788279.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be combined with bevacizumab (also referred to as an anti-PD-1 antibody))
Figure BDA0003990674580002101
) Co-administration (e.g. in the treatment of solid tumours) as described in clinical trial NCT 02715531.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be combined with bevacizumab (also referred to as an anti-PD-1 antibody))
Figure BDA0003990674580002102
) Folinic acid, oxaliplatin and optionally capecitabine (e.g. in the treatment of solid tumours), as described in clinical trial NCT 02715531.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., attrituximab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with albumin-bound paclitaxel and gemcitabine (e.g., in the treatment of a solid tumor), as described in clinical trial NCT 02715531.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., altlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with oxaliplatin, leucovorin, 5-fluorouracil (5-FU), oxaliplatin and cisplatin (e.g., in the treatment of a solid tumor), as described in clinical trial NCT 02715531.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as alemtuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with albumin-bound paclitaxel and carboplatin (e.g., in the treatment of lung cancer (e.g., squamous NSCLC), as described in clinical trial NCT 02367794.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., attrituximab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with paclitaxel and carboplatin (e.g., in the treatment of lung cancer (e.g., squamous NSCLC), as described in clinical trial NCT 02367794.
In some cases, a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as alemtuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) can be administered in combination with CPI-444 (e.g., in the treatment of advanced cancers (e.g., non-small cell lung cancer, malignant melanoma, renal cell carcinoma, triple negative breast cancer, microsatellite instability colorectal cancer (MSI), and bladder cancer)) as described in clinical trial NCT 02655822.
PD-L1 axis binding antagonists
PD-L1 axis binding antagonists include PD-L1 binding antagonists, PD-1 binding antagonists, and PD-L2 binding antagonists. PD-1 (programmed death 1) is also known in the art as "programmed cell death 1", "PDCD1", "CD279" and "SLEB2". An exemplary human PD-L1 is shown in UniProtKB/Swiss-Prot accession number Q9NZQ7.1. Exemplary human PD-1 is shown in UniProtKB/Swiss-Prot accession number Q15116. PD-L1 (programmed death ligand 1) is also known in the art as "programmed cell death 1 ligand 1", "PDCD1LG1", "CD274", "B7-H", and "PDL1". PD-L2 (programmed death ligand 2) is also known in the art as "programmed cell death 1 ligand 2", "PDCD1LG2", "CD273", "B7-DC", "Btdc" and "PDL2". Exemplary human PD-L2 is shown in UniProtKB/Swiss-Prot accession number Q9BQ 51. In some embodiments, PD-L1, PD-1, and PD-L2 are human PD-L1, PD-1, and PD-L2. In some cases, the PD-L1 axis binding antagonist can be a PD-L1 binding antagonist, a PD-1 binding antagonist, or a PD-L2 binding antagonist.
Any of the methods, compositions for use, uses, kits or articles of manufacture described herein can include or relate to any of the PDL-L1 axis binding antagonists described below.
In one aspect, the disclosure provides PD-L1 axis binding antagonists for use in, e.g., any one of the methods disclosed herein. In one embodiment, the PD-L1 axis binding antagonist is used to treat cancer. In one such embodiment, the method further comprises administering to the individual an effective amount of at least one additional therapeutic agent, such as any of the additional therapeutic agents disclosed herein.
In another aspect, the present disclosure provides the use of a PD-L1 axis binding antagonist for the manufacture or preparation of a medicament for use in any of the methods, e.g., disclosed herein. In one embodiment, the medicament is for treating cancer. In one such embodiment, the method further comprises administering to the individual an effective amount of at least one additional therapeutic agent, such as any of the additional therapeutic agents disclosed herein.
PD-L1 binding antagonists
In some cases, the PD-L1 binding antagonist inhibits the binding of PD-L1 to one or more of its ligand binding partners. In other cases, the PD-L1 binding antagonist inhibits the binding of PD-L1 to PD-1. In still other cases, the PD-L1 binding antagonist inhibits the binding of PD-L1 to B7-1. In some cases, the PD-L1 binding antagonist inhibits the binding of PD-L1 to both PD-1 and B7-1. In some cases, the PD-L1 binding antagonist is an antibody. In some cases, the antibody is selected from the group consisting of alemtuzumab, yw243.55.S70, MDX-1105, MEDI4736 (devaluzumab), and MSB0010718C (avizumab).
In some cases, the anti-PD-L1 antibody is a monoclonal antibody. In some cases, the anti-PD-L1 antibody is selected from the group consisting of Fab, fab '-SH, fv, scFv, and (Fab') 2 Antibody fragments of the group consisting of fragments. In some cases, the anti-PD-L1 antibody is a humanized antibody. In some cases, the anti-PD-L1 antibody is a human antibody. In some cases, an anti-PD-L1 antibody described herein binds to human PD-L1. In some particular cases, the anti-PD-L1 antibody is atelizumab (CAS registry number: 1422185-06-5). Astuzumab (genethak) is also known as MPDL3280A.
In some cases, an anti-PD-L1 antibody comprises a heavy chain variable region (HVR-H) comprising HVR-H1, HVR-H2, and HVR-H3 sequences, wherein:
(a) The HVR-H1 sequence is GFTFSDSWIH (SEQ ID NO: 1);
(b) The HVR-H2 sequence is AWISPYGGSTYYADSVKG (SEQ ID NO: 2); and is
(c) The HVR-H3 sequence is RHWGGFDY (SEQ ID NO: 3).
In some cases, the anti-PD-L1 antibody further comprises a light chain variable region (HVR-L) comprising HVR-L1, HVR-L2, and HVR-L3 sequences, wherein:
(a) The HVR-L1 sequence is RASQDVSTAVA (SEQ ID NO: 4);
(b) The HVR-L2 sequence is SASFLYS (SEQ ID NO: 5); and is
(c) The HVR-L3 sequence was QQYLYHPAT (SEQ ID NO: 6).
In some cases, the anti-PD-L1 antibody comprises heavy and light chain sequences, wherein:
(a) The heavy chain Variable (VH) region sequence comprises the amino acid sequence:
<xnotran> EVQLVESGGGLVQPGGSLRLSCAASGFTFSDSWIHWVRQAPGKGLEWVAWISPYGGSTYYADSVKGRFTISADTSKNTAYLQMNSLRAEDTAVYYCARRHWPGGFDYWGQGTLVTVSS (SEQ ID NO: 7); </xnotran> And is
(b) The light chain Variable (VL) region sequence comprises the amino acid sequence:
DIQMTQSPSSLSASVGDRVTITCRASQDVSTAVAWYQQKPGKAPKLLIYSASFLYSGVPSRFSGSGSGTDFTLTISSLQPEDFATYYCQQYLYHPATFGQGTKVEIKR(SEQ ID NO:8)。
in some cases, the anti-PD-L1 antibody comprises heavy and light chain sequences, wherein:
(a) The heavy chain comprises the following amino acid sequence:
<xnotran> EVQLVESGGGLVQPGGSLRLSCAASGFTFSDSWIHWVRQAPGKGLEWVAWISPYGGSTYYADSVKGRFTISADTSKNTAYLQMNSLRAEDTAVYYCARRHWPGGFDYWGQGTLVTVSSASTKGPSVFPLAPSSKSTSGGTAALGCLVKDYFPEPVTVSWNSGALTSGVHTFPAVLQSSGLYSLSSVVTVPSSSLGTQTYICNVNHKPSNTKVDKKVEPKSCDKTHTCPPCPAPELLGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKPREEQYASTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQPREPQVYTLPPSREEMTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPG (SEQ ID NO: 9); </xnotran> And is
(b) The light chain comprises the following amino acid sequence:
DIQMTQSPSSLSASVGDRVTITCRASQDVSTAVAWYQQKPGKAPKLLIYSASFLYSGVPSRFSGSGSGTDFTLTISSLQPEDFATYYCQQYLYHPATFGQGTKVEIKRTVAAPSVFIFPPSDEQLKSGTASVVCLLNNFYPREAKVQWKVDNALQSGNSQESVTEQDSKDSTYSLSSTLTLSKADYEKHKVYACEVTHQGLSSPVTKSFNRGEC(SEQ ID NO:10)。
in some cases, an anti-PD-L1 antibody comprises (a) a VH domain comprising an amino acid sequence having at least 95% sequence identity (e.g., at least 95%, 96%, 97%, 98%, or 99% sequence identity) to the sequence of SEQ ID No. 7, or a sequence comprising SEQ ID No. 7; (b) A VL domain comprising an amino acid sequence having at least 95% sequence identity (e.g., at least 95%, 96%, 97%, 98%, or 99% sequence identity) to the sequence of SEQ ID No. 8, or comprising the sequence of SEQ ID No. 8; or (c) a VH domain as described in (a) and a VL domain as described in (b). In other cases, the anti-PD-L1 antibody is selected from the group consisting of: YW243.55.S70, MDX-1105, MEDI4736 (Dewaruzumab) and MSB0010718C (Avermectin). Antibody YW243.55.S70 is anti-PD-L1 as described in PCT publication No. WO 2010/077634. MDX-1105 is also known as BMS-936559, an anti-PD-L1 antibody described in PCT publication No. WO 2007/005874. MEDI4736 (Devolumab) is an anti-PD-L1 monoclonal antibody described in PCT publication No. WO 2011/066389 and U.S. patent publication No. 2013/034559. anti-PD-L1 antibodies useful in the methods of the invention and methods of making the same are described in PCT publication nos. WO 2010/077634, WO2007/005874, and WO 2011/066389, as well as U.S. patent No. 8,217,149 and U.S. patent publication No. 2013/034559, which are incorporated herein by reference.
It is expressly contemplated that such PD-L1 binding antagonist antibodies for any one of the above-listed cases can have any of the features described in sections 1-7 below, alone or in combination.
PD-1 binding antagonists
In some cases, the PD-L1 axis binding antagonist is a PD-1 binding antagonist. For example, in some cases, a PD-1 binding antagonist inhibits the binding of PD-1 to one or more of its ligand binding partners. In some cases, the PD-1 binding antagonist inhibits the binding of PD-1 to PD-L1. In other cases, the PD-1 binding antagonist inhibits the binding of PD-1 to PD-L2. In still other cases, the PD-1 binding antagonist inhibits the binding of PD-1 to both PD-L1 and PD-L2. In some cases, the PD-1 binding antagonist is an antibody. In some cases, the antibody is selected from the group consisting of: MDX 1106 (nivolumab), MK-3475 (pembrolizumab), MEDI-0680 (AMP-514), PDR001, REGN2810, and BGB-108. In some cases, the PD-1 binding antagonist is an Fc fusion protein. For example, in some cases, the Fc fusion protein is AMP-224.
In some embodiments, the PD-1 binding antagonist is a molecule that inhibits the binding of PD-1 to its ligand binding partner. In particular aspects, the PD-1 ligand binding partner is PD-L1 and/or PD-L2. In another embodiment, the PD-L1 binding antagonist is a molecule that inhibits the binding of PD-L1 to its binding partner. In particular aspects, the PD-L1 binding partner is PD-1 and/or B7-1. In another embodiment, the PD-L2 binding antagonist is a molecule that inhibits the binding of PD-L2 to its ligand binding partner. In a specific aspect, the PD-L2 binding ligand partner is PD-1. The antagonist can be an antibody, an antigen-binding fragment thereof, an immunoadhesin, a fusion protein or an oligopeptide.
In some embodiments, the PD-1 binding antagonist is an anti-PD-1 antibody (e.g., a human antibody, a humanized antibody, or a chimeric antibody), e.g., as described below. In some embodiments, the anti-PD-1 antibody is selected from the group consisting of: MDX-1106 (nivolumab), MK-3475 (pembrolizumab), MEDI-0680 (AMP-514), PDR001, REGN2810, and BGB-108.MDX-1106, also known as MDX-1106-04, ONO-4538, BMS-936558 or nivolumab, is an anti-PD-1 antibody described in WO 2006/121168. MK-3475, also known as pembrolizumab or Lambolizumab, is an anti-PD-1 antibody described in WO 2009/114335. In some embodiments, the PD-1 binding antagonist is an immunoadhesin (e.g., an immunoadhesin comprising an extracellular or PD-1 binding portion of PD-L1 or PD-L2 fused to a constant region (e.g., the Fc region of an immunoglobulin sequence)). In some embodiments, the PD-1 binding antagonist is AMP-224.AMP-224, also known as B7-DCIg, is a PD-L2-Fc fusion soluble receptor described in WO 2010/027827 and WO 2011/066342.
In some embodiments, the anti-PD-1 antibody is MDX-1106. Alternative names for "MDX-1106" include MDX-1106-04, ONO-4538, BMS-936558, and nivolumab. In some embodiments, the anti-PD-1 antibody is nivolumab (CAS registry number: 946414-94-4). In yet another embodiment, an isolated anti-PD-1 antibody is provided, which antibody comprises: a heavy chain variable region comprising the heavy chain variable region amino acid sequence of SEQ ID NO 11; and/or a light chain variable region comprising the light chain variable region amino acid sequence of SEQ ID NO 12.
In yet another embodiment, an isolated anti-PD-1 antibody is provided, which antibody comprises heavy and/or light chain sequences, wherein:
(a) The heavy chain sequence has at least 85%, at least 90%, at least 91%, at least 92%, at least 93%, at least 94%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99% or 100% sequence identity to the heavy chain sequence of seq id no:
<xnotran> QVQLVESGGGVVQPGRSLRLDCKASGITFSNSGMHWVRQAPGKGLEWVAVIWYDGSKRYYADSVKGRFTISRDNSKNTLFLQMNSLRAEDTAVYYCATNDDYWGQGTLVTVSSASTKGPSVFPLAPCSRSTSESTAALGCLVKDYFPEPVTVSWNSGALTSGVHTFPAVLQSSGLYSLSSVVTVPSSSLGTKTYTCNVDHKPSNTKVDKRVESKYGPPCPPCPAPEFLGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSQEDPEVQFNWYVDGVEVHNAKTKPREEQFNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKGLPSSIEKTISKAKGQPREPQVYTLPPSQEEMTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLYSRLTVDKSRWQEGNVFSCSVMHEALHNHYTQKSLSLSLGK (SEQ ID NO: 11), </xnotran>
(b) The light chain sequence has at least 85%, at least 90%, at least 91%, at least 92%, at least 93%, at least 94%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% sequence identity to a light chain sequence that is:
EIVLTQSPATLSLSPGERATLSCRASQSVSSYLAWYQQKPGQAPRLLIYDASNRATGIPARFSGSGSGTDFTLTISSLEPEDFAVYYCQQSSNWPRTFGQGTKVEIKRTVAAPSVFIFPPSDEQLKSGTASVVCLLNNFYPREAKVQWKVDNALQSGNSQESVTEQDSKDSTYSLSSTLTLSKADYEKHKVYACEVTHQGLSSPVTKSFNRGEC(SEQ ID NO:12)。
It is specifically contemplated that such PD-1 binding antagonist antibodies for any one of the above-listed circumstances can have any of the features described in sections 1-7, below, alone or in combination.
C. Antibodies
1. Affinity of antibody
In certain instances, an antibody provided herein (e.g., an anti-PD-L1 antibody or an anti-PD-1 antibody) has a dissociation constant (Kd) of less than or equal to 1 μ M, less than or equal to 100nM, less than or equal to 10nM, less than or equal to 1nM, less than or equal to 0.1nM, less than or equal to 0.01nM, or less than or equal to 0.001nM (e.g., 10 nM) -8 M or less, e.g. 10 -8 M to 10 -13 M, e.g. 10 -9 M to 10 -13 M)。
In one instance, kd is measured by a radiolabeled antigen binding assay (RIA). In one example, RIA is performed using Fab forms of the antibody of interest and its antigen. For example, by using a minimum concentration in the presence of a series of unlabeled antigen titrations ( 125 I) The solution binding affinity of Fab to antigen was measured by equilibration of the Fab with labeled antigen and subsequent capture of the bound antigen with an anti-Fab antibody coated plate (see, e.g., chen et al, J.mol.biol.293:865-881 (1999)). To determine the conditions for the assay, capture anti-Fab antibodies (Cappel Labs) were coated with 5. Mu.g/ml in 50mM sodium carbonate (pH 9.6)
Figure BDA0003990674580002161
The plate (Thermo Scientific) was blocked overnight, then for two to five hours at room temperature (about 23 ℃) with 2% (w/v) bovine serum albumin in PBS. In the non-adsorption plate (Nunc # 269620), mixing 100pM or 26pM 125 I]Mixing of antigen with serial dilutions of Fab of interest (e.g.following the assessment of anti-VEGF antibodies (Fab-12) in Presta et al, cancer Res.57:4593-4599 (1997)). Then incubating the target Fab overnight; however, incubation may be continued for a longer period of time (e.g., about 65 hours) to ensure equilibrium is reached. Thereafter, the mixture is transferred to a capture plate for incubation at room temperature (e.g., one hour). The solution was then removed and used with 0.1% polysorbate 20 in PBS
Figure BDA0003990674580002162
The plate was washed eight times. When the plates had dried, 150. Mu.l/well of scintillator (MICROSCINT-20) was added TM (ii) a Packard) and in TOPCOUNT TM The gamma counter (Packard) counts the plate for tens of minutes. The concentration of each Fab that gave less than or equal to 20% maximal binding was selected for use in a competitive binding assay.
According to another case, use
Figure BDA0003990674580002171
Surface plasmon resonance assay measures Kd. For example, use
Figure BDA0003990674580002172
-2000 or
Figure BDA0003990674580002173
-3000 (BIAcore, inc., piscataway, NJ) was assayed at 25 ℃ with an immobilized antigen CM5 chip at about 10 Response Units (RU). In one case, carboxymethylated dextran biosensor chips (CM 5, BIACORE, inc.) were activated with N-ethyl-N '- (3-dimethylaminopropyl) -carbodiimide hydrochloride (EDC) and N-hydroxysuccinimide (NHS) according to supplier's instructions. Antigen was diluted to 5. Mu.g/ml (about 0.2. Mu.M) with 10mM sodium acetate, pH 4.8, followed by injection at a flow rate of 5. Mu.L/min to obtain approximately 10 response units A conjugated protein at position (RU). After injection of the antigen, 1M ethanolamine was injected to block unreacted groups. For kinetic measurements, injection containing 0.05% polysorbate 20 (TWEEN 20) was performed at 25 ℃ at a flow rate of about 25. Mu.L/min TM ) Two-fold serial dilutions (0.78 nM to 500 nM) of Fab in PBS of surfactant (PBST). Using a simple one-to-one Langmuir binding model: (
Figure BDA0003990674580002174
Evaluation Software version 3.2) for calculating association rates (k) by simultaneous fitting of association and dissociation sensor maps on ) And dissociation rate (k) off ). The equilibrium dissociation constant (Kd) is calculated as the ratio k off /k on . See, e.g., chen et al, J.mol.biol.293:865-881 (1999). If the association rate exceeds 10 as determined by the above surface plasmon resonance 6 M -1 s -1 The rate of association can then be determined by using a fluorescence quenching technique, e.g., in a spectrometer such as an Aviv Instruments or 8000 series SLM-AMINCO TM The increase or decrease in fluorescence emission intensity (excitation =295nM; emission =340nm, band pass at 1691m) of 20nM anti-antigen antibody (Fab form) in PBS pH 7.2 at 25 ℃ was measured in a spectrophotometer (ThermoSpectronic) with a stirred cuvette in the presence of increasing concentrations of antigen.
2. Antibody fragments
In certain instances, an antibody provided herein (e.g., an anti-PD-L1 antibody or an anti-PD-1 antibody) is an antibody fragment. Antibody fragments include, but are not limited to, fab '-SH, F (ab') 2 Fv, and scFv fragments, as well as other fragments described below. For a review of certain antibody fragments, see Hudson et al, nat. Med.9:129-134 (2003). For reviews on scFv fragments see, for example, pluckth ü n in The pharmacogolology of Monoclonal Antibodies, vol.113, rosenburg and Moore eds. (Springer-Verlag, new York), pp.269-315 (1994); see also WO 93/16185; and U.S. Pat. nos. 5,571,894 and 5,587,458. For Fa containing salvage receptor binding epitope residues and having increased half-life in vivob and F (ab') 2 See U.S. Pat. No. 5,869,046 for a discussion of fragments.
Diabodies are antibody fragments with two antigen binding sites, which may be bivalent or bispecific. See, for example, EP 404,097; WO 1993/01161; hudson et al, nat. Med.9:129-134 (2003); and Hollinger et al, proc.natl.acad.sci.usa 90. Tri-and tetrad antibodies are also described in Hudson et al, nat. Med.9:129-134 (2003).
A single domain antibody is an antibody fragment comprising all or part of a heavy chain variable domain or all or part of a light chain variable domain of an antibody. In certain instances, the single domain antibody is a human single domain antibody (Domantis, inc., waltham, MA; see, e.g., U.S. Pat. No. 6,248,516B1).
Antibody fragments can be prepared by a variety of techniques, including but not limited to proteolytic digestion of intact antibodies and production by recombinant host cells (e.g., e.coli or phage), as described herein.
3. Chimeric and humanized antibodies
In certain instances, an antibody provided herein (e.g., an anti-PD-L1 antibody or an anti-PD-1 antibody) is a chimeric antibody. Certain chimeric antibodies are described, for example, in U.S. Pat. No. 4,816,567 and Morrison et al, proc. Natl. Acad. Sci. USA, 81. In one example, a chimeric antibody comprises a non-human variable region (e.g., a variable region derived from a mouse, rat, hamster, rabbit, or non-human primate (such as a monkey)) and a human constant region. In another example, a chimeric antibody is a "class switch" antibody in which the class or subclass has been altered from that of the parent antibody. Chimeric antibodies include antigen-binding fragments thereof.
In certain instances, the chimeric antibody is a humanized antibody. Typically, non-human antibodies are humanized to reduce immunogenicity to humans, while retaining the specificity and affinity of the parent non-human antibody. Typically, a humanized antibody comprises one or more variable domains in which HVRs, e.g., CDRs (or portions thereof), are derived from a non-human antibody and FRs (or portions thereof) are derived from a human antibody sequence. The humanized antibody optionally will also comprise at least a portion of a human constant region. In some examples, some FR residues in a humanized antibody are replaced with corresponding residues from a non-human antibody (e.g., the antibody from which the HVR residues are derived), e.g., to restore or improve antibody specificity or affinity.
Humanized antibodies and methods for their preparation are reviewed, for example, in Almagro and Fransson, front.biosci.13:1619-1633 (2008), and are further described, for example, in Riechmann et al, nature 332; queen et al, proc. Natl. Acad. Sci. USA86:10029-10033 (1989); U.S. Pat. nos. 5,821,337, 7,527,791, 6,982,321, and 7,087,409; kashmiri et al, methods 36 (2005) (describes Specificity Determining Region (SDR) grafting); padlan, mol.Immunol.28:489-498 (1991) (described as "surface remodeling"); dall' Acqua et al, methods 36 (2005) (describing "FR shuffling"); and Osbourn et al, methods 36 (2005) and Klimka et al, br.J. cancer,83, 252-260 (2000) (describing the "guided selection" method for FR shuffling).
Human framework regions that may be used for humanization include, but are not limited to: framework regions selected using a "best fit" approach (see, e.g., sims et al J. Immunol.151:2296 (1993)); the framework regions derived from the consensus sequence of a human antibody from a particular subgroup of light or heavy chain variable regions (see, e.g., carter et al Proc. Natl. Acad. Sci. USA,89 4285 (1992); and Presta et al J. Immunol.,151 (1993)); human mature (somatic mutation) framework regions or human germline framework regions (see, e.g., almagro and Fransson, front. Biosci.13:1619-1633 (2008)); and framework regions derived from screening FR libraries (see, e.g., baca et al, J.biol. Chem.272:10678-10684 (1997) and Rosok et al, J.biol. Chem.271:22611-22618 (1996)).
4. Human antibodies
In certain instances, an antibody provided herein (e.g., an anti-PD-L1 antibody or an anti-PD-1 antibody) is a human antibody. Human antibodies can be produced using various techniques known in the art. Human antibodies are generally described in van Dijk and van de Winkel, curr Opin pharmacol.5:368-74 (2001) and Lonberg, curr Opin immunol.20:450-459 (2008).
Can pass throughHuman antibodies were prepared in the following manner: the immunogen is administered to a transgenic animal that has been modified to produce a fully human antibody or a fully antibody with human variable regions in response to antigen challenge. Such animals typically contain all or part of a human immunoglobulin locus that replaces an endogenous immunoglobulin locus, or is present extrachromosomally or randomly integrated into the chromosome of the animal. In such transgenic mice, the endogenous immunoglobulin loci have typically been inactivated. For an overview of the method for obtaining human antibodies from transgenic animals, see Lonberg, nat. Biotech.23:1117-1125 (2005). See also, for example, the description of XENOMOUSE TM U.S. Pat. nos. 6,075,181 and 6,150,584 to technology; description of the invention
Figure BDA0003990674580002191
U.S. Pat. nos. 5,770,429; description of K-M
Figure BDA0003990674580002192
U.S. Pat. No. 7,041,870 to the Art, and description
Figure BDA0003990674580002201
U.S. patent application publication No. US 2007/0061900 of the art. The human variable regions from intact antibodies produced by such animals may be further modified, for example by combination with different human constant regions.
Human antibodies can also be prepared by hybridoma-based methods. Human myeloma and mouse-human hybrid myeloma cell lines have been described for the production of human monoclonal antibodies. (see, e.g., kozbor J.Immunol.,133 (1984); brodeur et al, monoclonal Antibody Production Techniques and Applications, pp 51-63 (Marcel Dekker, inc., new York, 1987); and Boerner et al, J.Immunol.,147 (1991)), human antibodies produced via human B-cell hybridoma technology are also described by Li et al, proc.Natl.Acad.Sci.USA, 103. Additional methods include, for example, those described in U.S. Pat. No. 7,189,826 (describing the production of monoclonal human IgM antibodies from hybridoma cell lines) and Ni, xiandai Mianyixue,26 (4): 265-268 (2006) (describing human-human hybridomas). The human hybridoma technique (Trioma technique) is also described in Vollmers and Brandlein, histology and Histopathology,20 (3): 927-937 (2005) and Vollmers and Brandlein, methods and Findings in Experimental and Clinical Pharmacology,27 (3): 185-91 (2005).
Human antibodies can also be produced by isolating Fv clone variable domain sequences selected from a human phage display library. Such variable domain sequences can then be combined with the desired human constant domains. Techniques for selecting human antibodies from antibody libraries are described below.
5. Antibodies derived from libraries
Antibodies (e.g., anti-PD-L1 antibodies and anti-PD-1 antibodies) can be isolated by screening combinatorial libraries for antibodies having a desired activity. For example, various methods are known in the art for generating phage display libraries and screening such libraries for antibodies with desired binding characteristics. Such Methods are reviewed, for example, in Hoogenboom et al, methods in Molecular Biology 178, 1-37 (O' Brien et al, eds., human Press, totowa, NJ, 2001) and are further described, for example, in McCafferty et al, nature 348; clackson et al, nature 352; marks et al, J.mol.biol.222:581-597 (1992); marks and Bradbury, in Methods in Molecular Biology 248 161-175 (Lo, ed., human Press, totowa, NJ, 2003); sidhu et al, J.mol.biol.338 (2): 299-310 (2004); lee et al, J.mol.biol.340 (5): 1073-1093 (2004); fellouse, proc.natl.acad.sci.usa 101 (34); 12467-12472 (2004); and Lee et al, J.Immunol.methods 284 (1-2): 119-132 (2004).
In certain phage display methods, repertoires of VH and VL genes are individually cloned by Polymerase Chain Reaction (PCR) and randomly recombined in a phage library, from which antigen-binding phage can then be screened for, as described in Winter et al, ann.rev.immunol.,12 (1994). Phage typically display antibody fragments as single chain Fv (scFv) fragments or Fab fragments. Libraries from immunized sources provide high affinity antibodies to the immunogen without the need to construct hybridomas. Alternatively, all natural components (e.g., all natural components from humans) can be cloned to provide a single source of antibodies to a wide range of non-self and self-antigens without any immunization, as described by Griffiths et al, EMBO J, 12. Finally, the initial library can also be made by: cloning unrearranged V gene segments from stem cells; and the use of PCR primers containing randomized sequences to encode highly variable CDR3 regions and to accomplish in vitro rearrangement as described by Hoogenboom and Winter, j.mol.biol., 227. Patent publications describing human antibody phage libraries include, for example: U.S. Pat. No. 5,750,373, and U.S. publication Nos. 2005/0079574, 2005/0119455, 2005/0266000, 2007/0117126, 2007/0160598, 2007/0237764, 2007/0292936, and 2009/0002360.
Antibodies or antibody fragments isolated from a human antibody library are considered herein to be human antibodies or human antibody fragments.
6. Multispecific antibodies
In any of the above aspects, an antibody provided herein (e.g., an anti-PD-L1 antibody or an anti-PD-1 antibody) can be a multispecific antibody, e.g., a bispecific antibody. Multispecific antibodies are monoclonal antibodies having binding specificities for at least two different sites. In certain instances, the antibodies provided herein are multispecific antibodies, e.g., bispecific antibodies. In certain instances, one of the binding specificities is for PD-L1 and the other is for any other antigen. In certain instances, a bispecific antibody can bind two different epitopes of PD-L1. Bispecific antibodies may also be used to localize cytotoxic agents to cells expressing PD-L1. Bispecific antibodies can be prepared as full length antibodies or antibody fragments.
Techniques for making multispecific antibodies include, but are not limited to, recombinant co-expression of two immunoglobulin heavy chain-light chain pairs with different specificities (see, milstein and Cuello, nature 305 (1983), WO 93/08829 and Traunecker et al, EMBO j.10:3655 (1991)) and "hole-and-mortar" engineering (see, e.g., U.S. Pat. No. 5,731,168). Multispecific antibodies can also be made by the following techniques: engineering electrostatically manipulated effects to make antibody Fc-heterodimer molecules (see, e.g., WO 2009/089004 A1); cross-linking two or more antibodies or fragments (see, e.g., U.S. Pat. No. 4,676,980 and Brennan et al, science 229 (1985)); the use of leucine zippers to generate bispecific antibodies (see, e.g., kostelny et al, J.Immunol.148 (5): 1547-1553 (1992)); bispecific antibody fragments were made using the "diabody" technique (see, e.g., hollinger et al, proc. Natl. Acad. Sci. USA90:6444-6448 (1993)); single chain Fv (sFv) dimers were used (see, e.g., gruber et al, J.Immunol.152:5368 (1994)); and trispecific antibodies were prepared as described, for example, in Tutt et al J.Immunol.147:60 (1991).
Also included herein are engineered antibodies having three or more functional antigen binding sites, including "octopus antibodies" (see, e.g., US 2006/0025576 A1).
The antibodies or fragments herein also include "dual action fabs" or "DAFs" that comprise an antigen binding site that binds to PD-L1 as well as another, different antigen.
7. Antibody variants
In certain instances, amino acid sequence variants of the antibodies provided herein (e.g., anti-PD-L1 antibodies and anti-PD-1 antibodies) are contemplated. For example, it may be desirable to improve the binding affinity and/or other biological properties of an antibody. Amino acid sequence variants of an antibody can be prepared by introducing appropriate modifications into the nucleotide sequence encoding the antibody or by peptide synthesis. Such modifications include, for example, deletions from, and/or insertions into, and/or substitutions of, residues within the amino acid sequence of the antibody. Any combination of deletions, insertions, and substitutions can be made to arrive at the final construct, provided that the final construct possesses the desired characteristics, e.g., antigen binding.
I. Substitution, insertion and deletion variants
In certain instances, antibody variants are provided having one or more amino acid substitutions. Sites of interest for substitution mutations include HVRs and FRs. Conservative substitutions are shown in table a under the heading of "preferred substitutions". Further substantial changes are provided under the heading "exemplary substitutions" in table a, and are further described below with reference to amino acid side chain classes. Amino acid substitutions can be introduced into the antibody of interest and the product screened for a desired activity (e.g., retained/improved antigen binding, reduced immunogenicity, or improved antibody-dependent cell-mediated cytotoxicity (ADCC) or complement-dependent cytotoxicity (CDC)).
Exemplary and preferred amino acid substitutions
Figure BDA0003990674580002231
Amino acids can be grouped according to common side chain properties:
(1) Hydrophobicity: norleucine, met, ala, val, leu, ile;
(2) Neutral hydrophilicity: cys, ser, thr, asn, gln;
(3) Acidity: asp and Glu;
(4) Alkalinity: his, lys, arg;
(5) Residues that influence chain orientation: gly, pro;
(6) Aromatic: trp, tyr, phe.
Non-conservative substitutions will require the exchange of a member of one of these classes for another.
One type of substitution variant involves substituting one or more hypervariable region residues of a parent antibody (e.g., a humanized or human antibody). Typically, one or more of the resulting variants selected for further study will have modifications (e.g., improvements) in certain biological properties (e.g., increased affinity and/or reduced immunogenicity) relative to the parent antibody and/or will have certain biological properties of the parent antibody that are substantially retained. Exemplary substitution variants are affinity matured antibodies, which can be conveniently generated using phage display-based affinity maturation techniques such as those described herein, for example. Briefly, one or more HVR residues are mutated and variant antibodies are displayed on phage and screened for a particular biological activity (e.g., binding affinity).
For example, HVRs can be altered (e.g., substituted) to improve antibody affinity. Such changes can occur in HVR "hotspots", i.e., residues encoded by codons that undergo high frequency mutations during somatic maturation (see, e.g., chowdhury, methods mol. Biol.207:179-196 (2008)) and/or residues that come into contact with antigen (detecting binding affinity of the resulting variant VH or VL. Affinity maturation achieved by construction and reselection from secondary libraries has been described, for example, by Hoogenboom et al in Methods in Molecular Biology 178 (O' Brien et al, human Press, totowa, NJ, (2001)).
In certain examples, substitutions, insertions, or deletions may occur within one or more HVRs, so long as such alterations do not substantially reduce the ability of the antibody to bind antigen. For example, conservative changes that do not substantially reduce binding affinity (e.g., conservative substitutions as provided herein) may be made in HVRs. Such changes may be, for example, outside of antigen-contacting residues in HVRs. In certain examples of the variant VH and VL sequences provided above, each HVR is unchanged, or contains no more than one, two, or three amino acid substitutions.
A method that can be used to identify antibody residues or regions that can be targeted for mutagenesis is referred to as "alanine scanning mutagenesis" as described by Cunningham and Wells (1989) Science,244 1081-1085. In this method, a residue or set of target residues (e.g., charged residues such as Arg, asp, his, lys, and Glu) are identified and replaced with a neutral or negatively charged amino acid (e.g., alanine or polyalanine) to determine whether antibody interaction with an antigen is affected. Additional substitutions may be introduced at amino acid positions that exhibit functional sensitivity to the initial substitution. Alternatively or additionally, the crystal structure of the antigen-antibody complex is used to identify contact points between the antibody and the antigen. Such contact residues and adjacent residues that are candidates for substitution may be targeted or eliminated. Variants can be screened to determine if they possess the desired properties.
Amino acid sequence insertions include amino and/or carboxyl terminal fusions ranging in length from one residue to polypeptides containing a hundred or more residues, as well as intrasequence insertions of one or more amino acid residues. Examples of terminal insertions include antibodies with an N-terminal methionyl residue. Other insertional variants of the antibody molecule include fusions to the N-terminus or C-terminus of an antibody of an enzyme (e.g., for ADEPT) or polypeptide that increases the serum half-life of the antibody.
Glycosylation variants
In certain instances, the antibodies of the invention can be altered to increase or decrease the extent to which the antibody is glycosylated. The addition or deletion of glycosylation sites of the antibodies of the invention can be conveniently achieved by altering the amino acid sequence to create or remove one or more glycosylation sites.
When the antibody comprises an Fc region, the carbohydrate attached thereto may be altered. Natural antibodies produced by mammalian cells typically comprise branched, bi-antennary oligosaccharides typically linked by an N-bond to Asn297 of the CH2 domain of the Fc region. See, e.g., wright et al TIBTECH 15 (1997). Oligosaccharides may include various carbohydrates, for example, mannose, N-acetylglucosamine (GlcNAc), galactose, and sialic acid, as well as fucose attached to GlcNAc in the "backbone" of the biantennary oligosaccharide structure. In some examples, the oligosaccharides in the antibodies of the invention may be modified to produce antibody variants with certain improved properties.
In one instance, antibody variants are provided that have a carbohydrate structure that lacks fucose attached (directly or indirectly) to an Fc region. For example, the fucose content in such antibodies may be 1% to 80%, 1% to 65%, 5% to 65%, or 20% to 40%. The amount of fucose is determined by calculating the average amount of fucose at Asn297 in the sugar chain, relative to the sum of all sugar structures (e.g., complex, hybrid, and high mannose structures) attached to Asn297 as determined by MALDI-TOF mass spectrometry, as described in WO 2008/077546. Asn297 refers to the asparagine residue at about position 297 in the Fc region (EU numbering of Fc region residues); however, due to minor sequence variations in antibodies, asn297 may also be located approximately ± 3 amino acids upstream or downstream of position 297, i.e. between positions 294 and 300. Such fucosylated variants may have improved ADCC function. See, for example, U.S. patent publication Nos. US 2003/0157108 and US 2004/0093621. Examples of publications relating to "defucosylated" or "fucose-deficient" antibody variants include: US 2003/0157108; WO 2000/61739; WO 2001/29246; US 2003/0115614; US 2002/0164328; US 2004/0093621; US 2004/0132140; US 2004/0110704; US 2004/0110282; US 2004/0109865; WO 2003/085119; WO 2003/084570; WO 2005/035586; WO 2005/035778; WO2005/053742; WO2002/031140; okazaki et al, J.mol.biol.336:1239-1249 (2004); yamane-Ohnuki et al, biotech.Bioeng.87:614 (2004). Examples of cell lines capable of producing defucosylated antibodies include protein fucosylation deficient Lec13CHO cells (Ripka et al, arch. Biochem. Biophys.249:533-545 (1986); U.S. patent application No. US 2003/0157108 A1; and WO 2004/056312 A1, adams et al, particularly example 11), and knock-out cell lines, such as the alpha-1, 6-fucosyltransferase gene, FUT8 knock-out CHO cells (see, e.g., yamane-Ohnuki et al, biotech. Bioeng.87:614 (2004); kanda, Y. Et al, biotechnol. Bioeng.94 (4): 680-688 (2006); and WO 2003/085107).
Antibodies are also provided with bisected oligosaccharides, for example, where the biantennary oligosaccharides attached to the Fc region of the antibody are bisected by GlcNAc. Such antibody variants may have reduced fucosylation and/or improved ADCC function. Examples of such antibody variants are described, for example, in WO 2003/011878; U.S. Pat. nos. 6,602,684; and US 2005/0123546. Antibody variants having at least one galactose residue in an oligosaccharide linked to an Fc region are also provided. Such antibody variants may have improved CDC function. Such antibody variants are described, for example, in WO 1997/30087, WO 1998/58964 and WO 1999/22764.
Fc region variants
In certain examples, one or more amino acid modifications can be introduced into the Fc region of an antibody of the invention, thereby generating an Fc region variant. The Fc region variant may comprise a human Fc region sequence (e.g., a human IgG1, igG2, igG3, or IgG4 Fc region) comprising an amino acid modification (e.g., substitution) at one or more amino acid positions.
In certain instances, the disclosure contemplates antibody variants with some, but not all, effector functions, which make them desirable candidates for use where the half-life of the antibody in vivo is important and certain effector functions (such as complement and ADCC) are unnecessary or deleterious. In vitro and/or in vivo cytotoxicity assays may be performed to confirm the reduction/depletion of CDC and/or ADCC activity. For example, fc receptor (FcR) binding assays may be performed to ensure that the antibody lacks fcyr binding (and therefore may lack ADCC activity), but retains FcRn binding ability. The major cells mediating ADCC, NK cells, express Fc γ RIII only, whereas monocytes express Fc γ RI, fc γ RII and Fc γ RIII. FcR expression on hematopoietic cells is summarized in Table 3 on page 464 of ravatch and Kinet, annu.Rev.Immunol.9:457-492 (1991). Non-limiting examples of in vitro assays for assessing ADCC activity of a molecule of interest are described in U.S. patent nos. 5,500,362 (see, e.g., hellstrom, i.e., proc.natl.acad.sci.usa 83; U.S. Pat. No. 5,821,337 (see Bruggemann, M. Et al, J.Exp. Med.166:1351-1361 (1987)). Alternatively, non-radioactive assay methods may be employed (see, e.g., ACTI for flow cytometry) TM Non-radioactive cytotoxicity assay (CellTechnology, inc. Mountain View, CA); and CYTOTOX
Figure BDA0003990674580002271
Non-radioactive cytotoxicity assay (Promega, madison, WI)). Useful effector cells for such assays include Peripheral Blood Mononuclear Cells (PBMC) and autologous lymphocytesBut kill (NK) cells. Alternatively or additionally, the ADCC activity of the target molecule may be assessed in vivo, for example, in an animal model (such as disclosed in Clynes et al, proc.natl.acad.sci.usa 95-652-656 (1998)). A C1q binding assay may also be performed to confirm that the antibody is unable to bind C1q and therefore lacks CDC activity. See, e.g., the C1q and C3C binding ELISA in WO2006/029879 and WO 2005/100402. To assess complement activation, CDC assays can be performed (see, e.g., gazzano-Santoro et al, J.Immunol. Methods 202 (1996); cragg et al, blood.101:1045-1052 (2003); and Cragg et al, blood.103:2738-2743 (2004)). FcRn binding and in vivo clearance/half-life determinations can also be performed using methods known in the art (see, e.g., petkova et al, int' l. Immunol.18 (12): 1759-1769 (2006)).
Antibodies with reduced effector function include those with substitutions of one or more Fc region residues 238, 265, 269, 270, 297, 327 and 329 (U.S. Pat. nos. 6,737,056 and 8,219,149). Such Fc mutants include Fc mutants having substitutions at two or more of amino acid positions 265, 269, 270, 297 and 327, including so-called "DANA" Fc mutants having alanine substitutions for residues 265 and 297 (U.S. Pat. nos. 7,332,581 and 8,219,149).
Certain antibody variants with improved or reduced binding to FcR are described. ( See, e.g., U.S. Pat. nos. 6,737,056; WO 2004/056312; and Shields et al, J.biol.chem.9 (2): 6591-6604 (2001). )
In certain examples, an antibody variant comprises an Fc region with one or more amino acid substitutions that improve ADCC, e.g., substitutions at positions 298, 333, and/or 334 of the Fc region (EU numbering of residues).
In some cases, alterations are made in the Fc region, resulting in altered (i.e., improved or reduced) C1q binding and/or Complement Dependent Cytotoxicity (CDC), e.g., as described in U.S. Pat. Nos. 6,194,551, WO 99/51642 and Idusogene et al J.Immunol.164:4178-4184 (2000).
Antibodies with extended half-life and improved neonatal Fc receptor (FcRn) binding, responsible for the transfer of maternal IgG to the fetus (Guyer et al, J.Immunol.117:587 (1976); and Kim et al, J.Immunol.24:249 (1994)) are described in US2005/0014934A1 (Hinton et al). Those antibodies comprise an Fc region having one or more substitutions therein that improve binding of the Fc region to FcRn. Such Fc variants include those having substitutions at one or more of the following Fc region residues: 238. 256, 265, 272, 286, 303, 305, 307, 311, 312, 317, 340, 356, 360, 362, 376, 378, 380, 382, 413, 424 or 434, for example, a substitution of residue 434 of the Fc region (U.S. Pat. No. 7,371,826).
For additional examples of Fc region variants, see also: duncan and Winter, nature322:738-40 (1988); U.S. Pat. nos. 5,648,260; U.S. Pat. nos. 5,624,821; and WO 94/29351.
Cysteine engineered antibody variants
In certain instances, it may be desirable to produce cysteine engineered antibodies, e.g., "thiomabs," in which one or more residues of the antibody are replaced with cysteine residues. In particular examples, the substituted residue is present at an accessible site of the antibody. As further described herein, the reactive thiol groups are positioned at accessible sites of the antibody by substituting those residues with cysteine, and can be used to conjugate the antibody to other moieties (such as a drug moiety or linker-drug moiety) to produce an immunoconjugate. In certain examples, cysteine can be substituted for any one or more of the following residues: v205 of the light chain (Kabat numbering); a118 of the heavy chain (EU numbering); and S400 of the heavy chain Fc region (EU numbering). Cysteine-engineered antibodies can be produced as described, for example, in U.S. Pat. No. 7,521,541.
Antibody derivatives
In certain examples, the antibodies provided herein can be further modified to contain additional non-proteinaceous moieties known in the art and readily available. Moieties suitable for derivatization of antibodies include, but are not limited to, water-soluble polymers. Non-limiting examples of water-soluble polymers include, but are not limited to, polyethylene glycol (PEG), copolymers of ethylene glycol/propylene glycol, carboxymethylcellulose, dextran, polyvinyl alcohol, polyvinylpyrrolidone, poly-1, 3-dioxolane, poly-1, 3, 6-trioxane, ethylene/maleic anhydride copolymers, polyamino acids (homopolymers or random copolymers) and dextran or poly (n-vinylpyrrolidone) polyethylene glycol, propylene glycol homopolymers, polypropylene oxide/ethylene oxide copolymers, polyoxyethylated polyols (e.g., glycerol), polyvinyl alcohol, and mixtures thereof. Polyethylene glycol propionaldehyde may have advantages in manufacturing due to its stability in water. The polymer may have any molecular weight and may or may not have branches. The number of polymers attached to the antibody can vary, and if more than one polymer is attached, they can be the same or different molecules. In general, the number and/or type of polymers used for derivatization can be determined based on considerations including, but not limited to, the particular property or function of the antibody to be improved, whether the antibody derivative will be used in therapy under defined conditions, and the like.
In another example, a conjugate of an antibody and a non-proteinaceous moiety that can be selectively heated by exposure to radiation is provided. In one example, the non-proteinaceous moiety is carbon nanotubes (Kam et al, proc.natl.acad.sci.usa 102. The radiation can be of any wavelength, and includes, but is not limited to, wavelengths that are not harmful to normal cells, but that heat the non-proteinaceous part to a temperature at which cells proximal to the antibody-non-proteinaceous part are killed.
Immunoconjugates
The invention also provides immunoconjugates comprising an antibody provided herein (e.g., an anti-PD-L1 antibody or an anti-PD-1 antibody) conjugated to one or more cytotoxic agents, such as a chemotherapeutic agent or drug, a growth inhibitory agent, a toxin (e.g., a protein toxin, an enzymatic activity toxin, or a fragment thereof, of bacterial, fungal, plant or animal origin), or a radioisotope.
In one instance, the immunoconjugate is an antibody-drug conjugate (ADC) in which the antibody is conjugated to one or more drugs, including but not limited to maytansinoids (see U.S. Pat. nos. 5,208,020, 5,416,064 and european patent EP 0 425 235 B1); auristatins (auristatins), such as monomethyl auristatin drug moieties DE and DF (MMAE and MMAF) (see U.S. Pat. nos. 5,635,483 and 5,780,588 and 7,498,298); dolastatin; calicheamicin or derivatives thereof (see U.S. Pat. Nos. 5,712,374, 5,714,586, 5,739,116, 5,767,285, 5,770,701, 5,770,710, 5,773,001, and 5,877,296 Hinman et al, cancer Res.53:3336-3342 (1993); and Lode et al, cancer Res.58:2925-2928 (1998)); anthracyclines, such as daunorubicin or doxorubicin (see Kratz et al, current Med. Chem.13:477-523 (2006); jeffrey et al, bioorganic & Med. Chem. Letters 16; methotrexate; vinblastine; taxanes such as docetaxel, paclitaxel, larotaxel, tesetaxel, and otaxel; trichothecene and CC1065.
In another instance, the immunoconjugate comprises an antibody described herein conjugated to an enzymatically active toxin or fragment thereof, including but not limited to diphtheria a chain, a non-binding active fragment of diphtheria toxin, exotoxin a chain (from pseudomonas aeruginosa), ricin a chain, abrin a chain, modeccin a chain, alpha-hypoxanthine, erythrin, dianthin protein, phytolacca americana protein (PAPI, PAPII, and PAP-S), momordica charantia inhibitor, curcumin, croton toxin, saporin inhibitor, gelatin, clindamycin (mitogellin), restrictocin, phenomycin, enomycin, and trichothecene.
In another example, an immunoconjugate comprises an antibody described herein conjugated to a radioactive atom to form a radioconjugate. A variety of radioisotopes are available for the production of radioconjugates. Examples include At 211 、I 131 、I 125 、Y 90 、Re 186 、Re 188 、Sm 153 、Bi 212 、P 32 、Pb 212 And radioactive isotopes of Lu. When the radioconjugate is used for detection, it may contain a radioactive atom for scintigraphic studies, for example tc99m or I123, or a spin label for Nuclear Magnetic Resonance (NMR) imaging (also known as magnetic resonance imaging, mri), such as iodine-123, iodine-131, indium-111, fluorine-19, carbon-13, nitrogen-15, oxygen-17, gadolinium, manganese or iron. Conjugates of the antibody and cytotoxic agent may be prepared using a variety of bifunctional protein coupling agents, such as N-succinimidyl-3- (2-pyridyldithio) propionate (SPDP), succinimidyl-4- (N-maleimidomethyl) cyclohexane-1-carboxylate succinimidyl ester (SMCC), iminothiolane (IT), bifunctional derivatives of imidoesters (such as dimethyl adipate hydrochloride), active esters (such as disuccinimidyl suberate), aldehydes (such as glutaraldehyde), bis-azido compounds (such as bis (p-azidobenzoyl) hexanediamine), bis-diazonium derivatives (such as bis- (p-diazoniumbenzoyl) -ethylenediamine), diisocyanates (such as toluene 2, 6-diisocyanate), and bis-active fluorine compounds (such as 1, 5-difluoro-2, 4-dinitrobenzene). For example, a ricin immunotoxin may be prepared as described in Vitetta et al, science 238 (1987). Carbon-14 labeled 1-isothiocyanatobenzyl-3-methyldiethylene triaminepentaacetic acid (MX-DTPA) is an exemplary chelating agent for conjugating radionucleotides to antibodies. See WO94/11026. The linker may be a "cleavable linker" that promotes release of the cytotoxic drug in the cell. For example, acid-labile linkers, peptidase-sensitive linkers, photolabile linkers, dimethyl linkers, or disulfide-containing linkers can be used (Chari et al, cancer Res.52:127-131 (1992); U.S. Pat. No. 5,208,020).
Immunoconjugates or ADCs herein expressly contemplate, but are not limited to, such conjugates prepared with a cross-linking agent, including, but not limited to, commercially available (e.g., from Pierce Biotechnology, inc., rockford, il., u.s.a.) BMPS, EMCS, GMBS, HBVS, LC-SMCC, MBS, MPBH, SBAP, SIA, SIAB, SMCC, SMPB, SMPH, sulfo-EMCS, sulfo-GMBS, sulfo-KMUS, sulfo-MBS, sulfo-SIAB, sulfo-SMCC, sulfo-SMPB, and SVSB (succinimidyl- (4-vinylsulfone) benzoate).
Pharmaceutical compositions and formulations
The Pharmaceutical compositions and formulations described herein can be prepared in lyophilized formulations or in aqueous solution by mixing one or more active ingredients (e.g., anti-PD-L1 antibodies, such as atlizumab) of the desired purity with one or more optional Pharmaceutical carriers (Remington's Pharmaceutical Sciences 16 th edition, osol, a. Eds. (1980)). Pharmaceutically acceptable carriers are generally non-toxic to subjects at the dosages and concentrations used, and include, but are not limited to: buffers such as phosphates, citrates and other organic acids; antioxidants, including ascorbic acid and methionine; preservatives (such as octadecyl dimethyl benzyl ammonium chloride; hexamethonium chloride; benzalkonium chloride; benzethonium chloride; phenol, butanol or benzyl alcohol; alkyl parabens, such as methyl or propyl paraben; catechol; resorcinol; cyclohexanol; 3-pentanol; m-cresol); low molecular weight (less than about 10 residues) polypeptides; proteins, such as serum albumin, gelatin, or immunoglobulins; hydrophilic polymers such as polyvinylpyrrolidone; amino acids such as glycine, glutamine, asparagine, histidine, arginine, or lysine; monosaccharides, disaccharides, and other carbohydrates including glucose, mannose, or dextrins; chelating agents, such as EDTA; sugars such as sucrose, mannitol, trehalose, or sorbitol; salt-forming counterions, such as sodium; metal complexes (e.g., zinc protein complexes); and/or a non-ionic surfactant, such as polyethylene glycol (PEG). Exemplary pharmaceutical carriers herein further include interstitial drug dispersants, such as soluble neutral active hyaluronidase glycoprotein (sHASEGP), e.g., human soluble PH-20 hyaluronidase glycoprotein, such as rHuPH20 ((r))
Figure BDA0003990674580002321
Baxter International, inc.). Certain exemplary sHASEGP and methods of use, including rHuPH20, are described in U.S. patent publication Nos. 2005/0260186 and 2006/0104968. In one aspect, the sHASEGP is combined with one or more additional glycosaminoglycanases (such as chondroitinase). It should be understood thatAny of the pharmaceutical compositions or formulations described above can include an immunoconjugate described herein instead of or in addition to a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
Exemplary lyophilized antibody formulations are described in U.S. Pat. No. 6,267,958. Aqueous antibody formulations include those described in U.S. Pat. No. 6,171,586 and WO 2006/044908, the latter formulations comprising histidine-acetate buffer.
The compositions and formulations herein may also contain more than one active ingredient necessary for the particular indication being treated, preferably active ingredients having complementary activities that do not adversely affect each other. For example, it may be desirable to further provide additional therapeutic agents (e.g., chemotherapeutic agents, cytotoxic agents, growth inhibitory agents, and/or anti-hormonal agents, such as those described above). Such active ingredients are suitably present in combination in an amount effective for the intended purpose.
The active ingredient may be embedded in microcapsules prepared, for example, by coacervation techniques or by interfacial polymerization (for example, hydroxymethylcellulose or gelatin-microcapsules and poly (methylmethacylate) microcapsules, respectively); embedded in colloidal drug delivery systems (e.g., liposomes, albumin microspheres, microemulsions, nanoparticles, and nanocapsules); or embedded in the crude emulsion. Such techniques are disclosed in Remington's Pharmaceutical Sciences 16 th edition, osol, A. Eds (1980).
Sustained release preparations can be prepared. Suitable examples of sustained-release preparations include semipermeable matrices of solid hydrophobic polymers containing the antibody, which matrices are in the form of shaped articles, e.g., films, or microcapsules. Formulations for in vivo administration are generally sterile. Sterility can be readily achieved by filtration, for example, through sterile filtration membranes.
Article and kit
In another aspect of the present disclosure, an article of manufacture or a kit comprising materials for treating, preventing, and/or diagnosing a subject is provided.
In some cases, such articles of manufacture or kits can be used to identify an individual having cancer (e.g., lung cancer (e.g., NSCLC), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), or breast cancer (e.g., TNBC)) who may benefit from a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., attrituzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)). Such articles of manufacture or kits can include (a) reagents for determining the level of immune score expression of one or more of the genes in a sample from an individual, and (b) instructions for using these reagents to identify an individual having cancer (e.g., lung cancer (e.g., NSCLC), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), or breast cancer (e.g., TNBC)) who may benefit from treatment with a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., attritumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
For example, in some cases, an article of manufacture or kit can include (a) reagents for determining an immune score expression level of one or more genes listed in any one of tables 1 to 17 in a sample from an individual, and (b) instructions for using these reagents to identify individuals with cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) who may benefit from treatment with a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., altlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)).
In another example, provided herein is a kit comprising a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attritumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) and instructions for administering the PD-L1 axis binding antagonist to an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) who has been identified as an individual who may benefit from treatment with the PD-L1 binding antagonist according to any of the methods disclosed herein.
In another example, provided herein is a kit comprising a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, e.g., altlizumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)) and instructions to administer the PD-L1 axis binding antagonist to an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) for whom a treatment comprising the PD-L1 binding antagonist has been selected according to any one of the methods disclosed herein.
In another example, provided herein is a kit for identifying an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) who may benefit from treatment comprising a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attrituzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)), the kit comprising means for determining in a sample from the individual the expression levels of one or more of the genes CD79A, CD19, BANK1, jcain, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11) where the immune expression level of the one or more of the gene(s) would benefit from a high level of the identification of the PD-L1 axis binding antagonist in the individual.
In another example, provided herein is a kit for identifying an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) who may benefit from treatment comprising a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attrituzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)), the kit comprising means for determining the expression level of one or more of genes CD79A, CD19, BANK1, jcain, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual, wherein the individual is identified as a PD-L1 axis binding antagonist that may comprise a PD-L1 axis binding antagonist if the immune score expression level of the one or more genes is higher than a reference immune score expression level of the one or more genes, wherein the individual does not benefit from treatment comprising prolonged PD-L1 axis binding to the individual.
In some cases, the kit comprises reagents for determining the expression level of two or more of genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual. In some cases, the kit includes reagents for determining the expression levels of three or more of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual. In some cases, the kit includes reagents for determining the expression levels of four or more of genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual. In some cases, the kit includes reagents for determining the expression level of five or more of genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from an individual. In some cases, the kit comprises reagents for determining the expression level of six or more of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual. In some cases, the kit comprises reagents for determining the expression level of seven or more of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual. In some cases, the kit comprises reagents for determining the expression level of CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the subject.
The kit may include reagents for determining the expression level of any combination of B cell signature genes. For example, the combination may include two genes selected from CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1, e.g., any one of the combinations listed in table 3. In another example, the combination can include three genes selected from CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1, e.g., any one of the combinations listed in table 4. In another example, the combination can include four genes selected from CD79A, CD19, BANK1, jchan, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1, e.g., any one of the combinations listed in table 5. In another example, the combination can include five genes selected from CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1, e.g., any one of the combinations listed in table 6. In another example, the combination can include six genes selected from CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1, e.g., any one of the combinations listed in table 7. In another example, the combination may include seven genes selected from CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1, e.g., any one of the combinations listed in table 8.
In another example, provided herein is a kit for identifying an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) who is likely to benefit from treatment comprising a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as astuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)), the kit comprising means for determining in a sample from the individual one or more of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 13, 14, or more of the genes are expressed at a high immune score for the individual, wherein the individual is likely to benefit from expression of the reference level of the one or more of the individual.
In another example, provided herein is a kit for identifying an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) who may benefit from treatment comprising a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attrituzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)), the kit comprising reagents for determining the expression levels of one or more of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 in a sample from the individual, wherein a reference level of immune expression of the one or more genes at which is higher than the reference level of immune expression of the one or more genes would benefit from treatment comprising an extended PD-axis binding to the individual, wherein the subject would benefit from treatment using the PD-L1 axis binding antagonist.
In some cases, the kit includes reagents for determining the expression level of two or more of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 in a sample from an individual. In some cases, the kit comprises reagents for determining the expression level of three or more of the genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 in a sample from an individual. In some cases, the kit includes reagents for determining the expression level of four or more of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 in a sample from an individual. In some cases, the kit comprises reagents for determining the expression level of five or more of the genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 in a sample from an individual. In some cases, the kit comprises reagents for determining the expression level of six or more of the genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 in a sample from an individual. In some cases, the kit comprises reagents for determining the expression level of seven or more of the genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 in a sample from an individual. In some cases, the kit includes reagents for determining the expression level of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 in a sample from an individual.
The kit may include reagents for determining the expression level of any combination of plasma B cell signature genes. For example, the combination may include two genes selected from MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5, e.g., any one of the combinations listed in table 10. In another example, the combination may include three genes selected from MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5, e.g., any one of the combinations listed in Table 11. In another example, the combination may include four genes selected from MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5, e.g., any one of the combinations listed in table 12. In another example, the combination may include five genes selected from MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5, e.g., any one of the combinations listed in table 13. In another example, the combination may include six genes selected from MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5, e.g., any one of the combinations listed in table 14. In another example, the combination may include seven genes selected from MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5, e.g., any one of the combinations listed in table 15.
In another example, provided herein is a kit for identifying an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) who may benefit from treatment with a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attritumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)), the kit comprising reagents for determining the presence of TLS in a tumor sample from the individual, wherein the presence of TLS in the tumor sample identifies the individual as an individual who may benefit from treatment with a PD-L1 axis binding antagonist.
In another example, provided herein is a kit for identifying an individual having a cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., NSCLC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) who may benefit from treatment comprising a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as alemtuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)), the kit comprising a means for determining the expression level of one or more of genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, or 12) in a sample from the individual, wherein the immune expression level of the one or more genes is scored as high as a reference level of the individual's potential binding to benefit from the reference PD 1.
In some cases, a kit comprises reagents for determining the expression level of two or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from an individual. In some cases, a kit comprises reagents for determining the expression levels of three or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from an individual. In some cases, a kit comprises reagents for determining the expression levels of four or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from an individual. In some cases, a kit comprises reagents for determining the expression level of five or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from an individual. In some cases, a kit comprises reagents for determining the expression level of six or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from an individual. In some cases, a kit comprises reagents for determining the expression level of seven or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from an individual. In some cases, a kit comprises reagents for determining the expression level of eight or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from an individual. In some cases, a kit comprises reagents for determining the expression level of nine or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from an individual. In some cases, a kit comprises reagents for determining the expression level of ten or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from an individual. In some cases, a kit comprises reagents for determining the expression level of eleven or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from an individual. In some cases, a kit comprises reagents for determining the expression level of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from an individual.
In another example, provided herein is a kit for identifying an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) who may benefit from treatment comprising a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as atuzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)), the kit comprising determining the number of B cells in a tumor sample from the individual, wherein the individual is identified as an individual who may benefit from treatment comprising a PD-L1 axis binding antagonist if the number of B cells in the tumor sample is greater than a reference number of B cells.
In another example, provided herein is a kit for identifying an individual having cancer (e.g., lung cancer (e.g., NSCLC)), bladder cancer (e.g., UC), kidney cancer (e.g., RCC), and breast cancer (e.g., TNBC)) who may benefit from treatment with a PD-L1 axis binding antagonist (e.g., a PD-L1 binding antagonist (e.g., an anti-PD-L1 antibody, such as attrituzumab) or a PD-1 binding antagonist (e.g., an anti-PD-1 antibody)), the kit comprising reagents for determining whether the individual has clonally expanded B cells in a tumor sample from the individual, wherein the clonally expanded B cells in the sample identify the individual as an individual who may benefit from treatment with a PD-L1 axis binding antagonist.
Either of the articles or kits may further comprise carrier means compartmentalized to receive within a well-defined space one or more container means (such as vials, tubes, etc.), wherein each of the container means comprises one of the individual elements to be used in the method. In the case of articles or kits for detecting target nucleic acids using nucleic acid hybridization, the kit may also have a container containing nucleotides for amplifying the target nucleic acid sequence and/or a container containing a reporter molecule such as an enzymatic, fluorescent, or radioisotope label.
In some cases, the article of manufacture or kit comprises the above-described container and one or more other containers comprising materials desirable from a commercial and user standpoint, including buffers, diluents, filters, needles, syringes, and package inserts with instructions for use. A label may be present on the container to indicate that the composition is for a particular application, and may also indicate guidelines for in vivo or in vitro use, such as those described above. For example, the article of manufacture or kit may further comprise a container comprising a pharmaceutically acceptable buffer, such as bacteriostatic water for injection (BWFI), phosphate buffered saline, ringer's solution, and dextrose solution.
The articles of manufacture or kits described herein can have many embodiments. In one instance, an article of manufacture or a kit comprises a container, a label on the container, and a composition contained within the container, wherein the composition comprises one or more polynucleotides that hybridize under stringent conditions to a complement of a gene listed herein (e.g., one or more genes listed in any one of tables 1-17), and the label on the container indicates that the composition can be used to assess a sample for the presence of a gene listed herein (e.g., one or more genes listed in any one of tables 1-17), and wherein the kit comprises instructions for using the one or more polynucleotides for assessing the presence of gene RNA or DNA in a particular sample type.
For oligonucleotide-based articles or kits, the article or kit can include, for example: (1) An oligonucleotide, e.g., a detectably labeled oligonucleotide, that hybridizes to a nucleic acid sequence encoding a protein, or (2) a pair of primers useful for amplifying a nucleic acid molecule. The article of manufacture or kit may also include, for example, a buffer, a preservative, or a protein stabilizing agent. The article of manufacture or kit may further comprise components necessary for the detection of a detectable label (e.g., an enzyme or substrate). The article of manufacture or kit can further comprise a control sample or a series of control samples that can be assayed and compared to the test sample. Each component of the article of manufacture or kit can be enclosed within a separate container, and all of the various containers and instructions for interpreting the results of the assays performed using the kit can be in separate packages.
In one instance, an article of manufacture or kit comprises a container, a label on the container, and a composition contained within the container, wherein the composition comprises one or more antibodies that specifically bind under stringent conditions to any of the biomarkers disclosed herein (e.g., one or more genes, TLS, or B cells (including clonally expanded B cells) listed in any one of tables 1 to 17), and the label on the container indicates that the composition can be used to assess the presence of the biomarkers listed herein in a sample, and wherein the kit comprises instructions for using the one or more antibodies for assessing the presence of a biomarker in a particular sample type.
VII. examples
The following are examples of the process of the present invention. It is to be understood that various other embodiments may be practiced given the general description provided above.
Example 1 tumor infiltrating B cells (including plasma B cells) and tertiary lymphoid structures are correlated with tumor response to PD-L1 blockade in NSCLC
Unsupervised differential analysis of gene expression was performed in pre-treatment biopsies of the phase 2 POPLAR trial (NCT 01903993). The study confirmed the results of phase 3 OAK (NCT 02008227) and BIRCH (NCT 02031458) clinical trials. This analysis, described in more detail in this example, reveals a strong correlation between the presence of B cells (particularly plasma B cells) and Tertiary Lymphoid Structures (TLS) in a patient's tumor and the continued manifestation of the sustained survival benefits associated with atezumab.
Unsupervised differential gene expression analysis showed that the B cell genes were associated with Overall Survival (OS) following alemtuzumab treatment
Whole genome RNA sequence data from archived tumor samples from POPLAR trial patients were analyzed. Gene expression data for patients with <6 months of survival (n = 24) receiving treatment with atelizumab and patients with > 12 months of survival (n = 43) were compared (Lee, J. Et al, reinvigorating activated T Cells by Block of the PD-1 pathway for Immunopathol. Dis. Therap.6,7-17 (2015)). Unsupervised differential gene expression analysis showed that, after correction of multiple hypothesis tests, multiple B cell genes were significantly associated with OS in addition to the expected T cell effector genes (fig. 1A and 7).
To assess whether these B cell gene signatures (CD 79A, SLAMF7, BTK, TNFRSF17, IGJ or jcain, IGLL5, RBPJ and MZB 1) were associated with OS in both treatment groups, the mean z scores for these genes were associated with benefit in the alemtuzumab group (greater than median, HR =0.39, ci =0.22-0.68, p < <0.001) and less relevant with chemotherapy or docetaxel treatment (HR =0.74, ci =0.52-1.07, p =0.1 relative to docetaxel) (fig. 1B). Among all these genes, the B cell receptor gene (CD 79A) was one of the most significantly differentially expressed genes, and high expression of CD79A was associated with OS benefit in the alemtuzumab-treated group (greater than median, HR =0.36, ci =0.2-0.64, p < -0.001) (fig. 1C).
B cell transcriptional signature was associated with prolonged OS in patients receiving treatment with atelizumab
Attempts were also made to identify Differentially Expressed Genes (DEG) between tumors in astuzumab responders and non-responders in OAK, comparing patients with long survival (> 12 months, n = 313) versus patients with short survival (< 6 months, n = 205) within each treatment group. 817 genes are differentially expressed between patients with long OS or short OS who received treatment with astuzumab (P <0.01 after FDR correction, absolute logFC ≧ 0.5). Genes with high degrees of overexpression were enriched in genes associated with B and plasma cell biology, including CD19, CD79A, BANK1, JCHAIN, MZB1, and TNFRSF17 (BCMA) (fig. 15A). Genes associated with cytotoxic T cell and IFN signaling (CD 3E, D, G, CD8A, GZMA-B, IFNG, CXCL 9-10) were also detected, but not significantly. None of these genes were significant in the docetaxel group (fig. 15B), indicating that these B/plasma cell genes have particular predictive value for the response to alemtuzumab. These observations were validated in phase II randomized clinical trial POPLAR (fig. 21A and 21B).
The results of the linear modeling were then verified by deriving a Kaplan-Meier curve in OAK, classifying gene expression by the tertile and comparing combined high (T3) and low/moderate (T1-T2) expression. The B cell markers CD79A (HR alemtuzumab: 0.54[ 2] 0.41-0.72]; HR chemotherapy: 0.88[0.67-1.13 ]) and CD19 (HR alemtuzumab: 0.65[0.50-0.86]; HR chemotherapy: 0.94[0.72-1.2 ]) provide an increased OS benefit as compared to IFNG (HR alemtuzumab: 0.73[0.55-0.96]; HR chemotherapy: 0.95[0.73-1.23 ]) or IFN-inducible chemokine CXCL10 (HR alemtuzumab: 0.85[0.65-1.11]; HR chemotherapy: 1.11[0.85-1.44 ]) (FIG. 15C-15F). Also, similar results were observed in POPLAR (fig. 21C to 21F).
To confirm these transcriptional findings at the protein level, baseline tumor samples from two attritumab responders and two attritumab non-responders were evaluated by Immunofluorescence (IF) staining for CD8, CD79, and Ki67 using multiple IFs. Abundant CD79+ B cells were detected in tumors from patients with objective remission compared to patients without objective remission (fig. 15G). In addition, multiple Immunohistochemistry (IHC) detected regions in which CD8+ T cells were immediately adjacent (9.9 ± 1.69 μm apart) to CD79+ B cells, suggesting that there was B cell-T cell interaction.
Identification of B cell subpopulations by Single cell RNA-seq
To further characterize the B-cell compartments involved in response to atuzumab, a large scRNA-seq dataset of 208,506 cells collected from lung and peripheral tissues of 44 NSCLC patients was analyzed with a focus on the B/plasma cell population. Cells were aggregated from tumor and draining lymph node compartments, dimensionality reduction was performed using Unified Manifold Approximation and Projection (UMAP) and graph-based clustering, identifying three major CD79A + B cell subsets in tumors, including follicular B cells, germinal Center (GC) B cells, and plasma cells (fig. 16A). Although the number of B/plasma cells was found to be increased in tumor tissue compared to Normal Adjacent Tissue (NAT), the composition of GC, follicular B and plasma cells within these B cell populations was similar between tumors and NAT from the same patient (fig. 16B). Transcription characteristics unique to each subset are identified. Follicular B cells are rich in CD83, CD69, SELL and BANK1 (Aiba et al, 2006). Plasma cells are rich in several immunoglobulin transcripts (ighg2, 137ighgp, IGHA 2), MZB1, DERL3 and XBP1. Germinal center B cells are rich in HMGA1, HMGB2 and RGS13. These characteristics were refined by exploring the expression of these transcripts in various immune cells (bone marrow, NK and T cells), stroma (fibroblasts, endothelial cells) and epithelial/tumor cell populations from the same patient (fig. 22A), retaining only B-cell compartment specific genes. Further focus was on only markers with high specificity for a single B cell population (fig. 16C and 22A).
The transcription method was supplemented with mass cytometry using a CyTOF combination containing 38 markers for single cell suspensions from six purchased NSCLC tumors. The analysis confirmed the presence of three intratumoral B cell populations based on CD19, HLA-DR, CD38 and Ki67 staining (plasma cells: CD38+ +, HLA-DR-, ki67-; GC B cells: CD38+, HLA-DR +, ki67+; follicular B cells: CD38-, HLA-DR +, ki 67-) (FIG. 16D). These specific markers were also verified to have similar expression patterns in the scRNA-seq dataset (FIG. 22B). In summary, single cell analysis identified three major intratumoral B cell subsets with highly specific markers.
High plasma cell characteristics predict OS benefit from alemtuzumab
Then, it was investigated whether these B-cell characteristics identified according to the scRNA-seq analysis could predict the survival of patients after receiving treatment with attrituximab or docetaxel. First, by ensuring gene co-expression through hierarchical clustering (fig. 17A) and intergenic correlation (fig. 23), it was verified that scRNA-seq derived features can be applied to bulk RNA-seq data. These analyses showed that there was a high correlation between germinal center B cells and follicular B cells in a large number of tumors (fig. 17b, r = 0.74), whereas tumors with high plasma cells were more pronounced. Plasma, GC B and follicular B cell characteristics are summarized in table 18.
Table 18: follicular B cell, GC B cell, and plasma B cell gene signatures
Follicular B cells GC B cells Plasma cells
BANK1 GCSAM MZB1
LINC00926 LRMP DERL3
FCER2 AICDA JSRP1
GAPT AC023590.1 TNFRSF17
HVCN1 SUSD3 SLAMF7
IGHG2
IGHGP
IGLV3-1
IGLV6-57
IGHA2
IGKV4-1
IGKV1-12
IGLC7
IGLL5
These features were then bisected using a three-place score split and comparing groups expressing high (T3) with low/medium (T1/T2). Kaplan-Meier analysis showed that although a tendency of OS benefit was observed with atuzumab in three characteristics, only plasma cell characteristics were significant (atuzumab high vs. low HR =0.63, 0.48-0.83]; chemotherapy high vs. low HR =0.92, 0.71-1.2; atuzumab high vs. chemotherapy high HR =0.64, 0.47-0.88) (FIGS. 18A-18D). In addition, tumors with high plasma cells showed significantly more patients experiencing complete remission, partial remission, or optimal overall remission with sustained stable disease (SD ≧ 6 months) (FIG. 24A). In POPLAR, there was also similar significant stratification of plasma cell characteristics for overall survival (fig. 24B-24D). The predictive value of plasma cell characteristics was confirmed in the model that tested the interaction of each characteristic with the treatment group (fig. 18E). Importantly, GC B cells, follicular B cells and our 8 gene T effector signature tGE8 (consisting of IFNG, CXCL9, CD8A, GZMA, GZMB, CXCL10, PRF1, TBX 21) were not significant in these models (fig. 18E). The predicted values of plasma cell characteristics were also present in a multivariate model including all four characteristics (atlizumab HR =0.67, [0.50-0.89]; chemotherapy HR =0.94, [0.70-1.26 ]), confirming that the effects observed with plasma cell characteristics are specific and independent of the presence of CD 8T cells (FIG. 18F). Increased B cells have been described as having prognostic significance for TCGA, among other indications; however, our data indicate that NSCLC tumors rich in plasma cells have strong predictive signatures, particularly for immune checkpoint inhibition. Indeed, plasma cell characteristics split by the three-score split method in TCGA NSCLC tumors had no effect on stratification of overall survival (fig. 24E). Taken together, these data indicate that plasma cell-rich tumors are predictive of overall survival benefit in patients receiving specific immune checkpoint inhibitor therapy.
Enriched plasma cell characteristics in tumors with tertiary lymphoid structures and/or lymphoid aggregates
In POPLAR, tumor hematoxylin and eosin (H & E) slides were evaluated for the presence of only TLS or lymphoid aggregates (LA, no germinal centers observed) (fig. 19A). Of the 254 patient samples analyzed, 9% had TLS-like structures with germinal centers, 21% had lymph aggregates (no germinal centers observed), and the remaining 70% had no detectable TLS-like or lymph aggregates. Lymph node metastasis samples (4% of all samples) were excluded from the analysis (fig. 19B). Patients with tumors containing TLS and/or LA showed a significant increase of 191OS (HR =0.60 2 2.38-0.94) when receiving treatment with atelizumab, but not when receiving treatment with docetaxel (HR =0.93 2-0.1.41) (fig. 19C).
A linear model was then applied to identify DEG between TLS/LA + and TLS/LA-tumors. 928 genes were differentially expressed between the two groups (P <0.01 after FDR correction, absolute logFC > 0.5). TLS/LA + tumors were highly enriched with genes from three intratumoral B cell subsets, but especially plasma cell genes (including MZB1, TNFRSF17 (BCMA) and immunoglobulins (fig. 20A and 20B.) quantitative analysis of the three B cell characteristics confirmed an increase in plasma cells (P =4.1 e-12) in TLS/LA + tumors as well as GC B cells (P =2.6 e-07) and follicular B cell characteristics (P =5.3 e-05) (fig. 20C).
In summary, our study integrated batch transcriptome and single cell RNA and protein measurements from two large randomized clinical trials of attrituzumab and docetaxel, demonstrating that baseline plasma cell enrichment in NSCLC tumors is an effective predictor of OS benefit following immune checkpoint blockade.
The correlation of clinical benefit of B cells after treatment with astuzumab was confirmed in an independent clinical trial dataset
To confirm the above results, two independent clinical data sets, i.e. BIRCH (n = 591) and OAK (n = 727), were analyzed. Interestingly, in the randomized phase 3 OAK study, high expression of B cell characteristics was associated with OS benefit in the chemotherapy and alemtuzumab treated groups, with greater benefit observed in the alemtuzumab treated group (fig. 2A). These data indicate that high expression of B cell features may have both prognostic and predictive components for OS (greater than median, HR =0.84, ci =0.71-1, p =0.056 relative to docetaxel, and HR =0.54, ci =0.42-0.7, p <0.001 relative to the less-than-median B cell gene set within the attritumab group). Similarly, in phase 3 BIRCH studies with single-therapy single-panel PD-L1 selection (immune or tumor cell positive rate greater than 5%), high expression of B cell signatures was found to be associated with OS benefit in patients receiving treatment with atelizumab (HR =0.78, ci =0.62-0.99, p = 0.044) (fig. 2B).
The best-confirmed overall response (BCOR) and progression-free survival (PFS) in the OAK study were also evaluated. Responders to alemtuzumab showed significantly higher B-cell signature gene expression than non-responders, and this difference was not observed in patients receiving docetaxel treatment (fig. 2C). Similar to the association with OS, high expression of B cell gene signatures was associated with greater PFS benefit in both treatment groups, with greater benefit observed in the alemtuzumab group (greater than median, HR =0.54, ci =0.42-0.7, p < -0.001) or relative to docetaxel (HR =0.84, ci =0.71-1, p = 0.056) (fig. 2D). High B cell characteristics were associated with greater benefit of lung tumors (except lymph node metastases), regardless of histology or sample type (biopsy or resection) (fig. 14A to 14C).
Confirming the presence of B cells in a NSCLC sample from a patient
To confirm whether these gene expression results in the presence of CD79+ B cells in NSCLC tumors, CD8, CD79 and Ki67 in baseline tumor samples from 20 patients were evaluated by IF staining using multiple Immunofluorescence (IF). These patient samples had high or low CD79A gene expression (fig. 3A). Abundant CD79+ B cells were detected in NSCLC samples with high CD79A RNA. Furthermore, multiple Immunohistochemistry (IHC) detected regions in which CD8+ T cells were in close proximity (9.9 ± 1.69 μm apart) to CD79+ B cells, suggesting that there was B cell-T cell interaction.
The association of the B cell gene CD79A with OS is independent of the T cell gene
The presence of T cells in the tumor microenvironment can up-regulate cytokines and chemokines that non-specifically recruit other immune cells. To assess whether B cells present in a tumor are likely bystander cells recruited into the tumor due to infiltrating T cells, and given that immune cell genes are generally highly correlated (in our data set, r for CD79A and CD8A, for example) 2 =0.58, r for CD3D and CD79A 2 =0.61, using Cox proportional airMultivariate regression analysis at risk to assess whether the association of CD79A (B cell receptor gene) is dependent on CD3D, CD3E, CD8A gene and T eff The presence of genetic characteristics. This method has been used to assess tumor-infiltrating lymphocyte (TIL) anatomy in colorectal cancer (CRC) and novel immune characteristics in hepatocellular carcinoma (HCC) (Berntsson, J. Et al, the clinical impression of tumor-infiltrating lymphocytes in clinical cancer by cancer subsidiary sub site: A clinical study. Int. J. Cancer 141,1654-1666 (2017); tian, M.X. Et al, tissue-infiltrating lymphocytes signature prediction in Patients with early/interface Tissue specimen clinical specimen in cancer Carcinoma. BMC.20117, 106 (2019)). Using Cox proportional Risk multivariate regression analysis, in the analysis of CD3D, CD3E, CD8A genes or T eff The association of CD79A with OS was still statistically significant after gene expression was controlled as a covariate (table 19). This indicates that expression of the CD79A gene at baseline has a significant impact on OS risk ratio in patients receiving alemtuzumab treatment, independent of T cell genes in the tumor microenvironment.
Table 19: statistical analysis associated with Cox ratio risk survival analysis comparing CD79a and CD3 genes from POPLAR
Correlation with OS compared to CD3D
Figure BDA0003990674580002481
Likelihood ratio test =23.9 (on 2 df), p =6.44e-06, n =92, event number =51
Correlation with OS compared to CD3E
Figure BDA0003990674580002482
Likelihood ratio test =23.9 (at 2 df), p =6.44e-06, n =92, number of events =51
Correlation with OS compared to CD8A
Figure BDA0003990674580002483
Likelihood ratio test =23.45 (at 2 df), p =8.106e-06, n =92, event number =51
Compared with T eff Features, dependency on OS
Figure BDA0003990674580002491
Likelihood ratio test =23.95 (at 2 df), p =6.298e-06, n =93, number of events =52
High CD79A + tumors show the presence of Tertiary Lymphoid Structures (TLS)
To better understand the role of B cells in these tumors, tumor hematoxylin and eosin (H & E) slides were evaluated for the presence of TLS (fig. 3B). TLS is often observed in tissues affected by chronic inflammation caused by infection, autoimmunity, cancer and allograft rejection. These highly ordered structures, similar to the cellular composition of the lymphoid follicles, are thought to mimic the activity of germinal centers and contribute to the local control of the adaptive immune response. Of the 290 NSCLC patient samples analyzed, 31% had TLS with germinal centers, 30% had lymphatic aggregates (no germinal centers observed), and the remaining 39% had no detectable TLS or lymphatic aggregates. Lymph node metastasis samples (4% of all samples) were excluded from the analysis. In this cohort, TLS and lymphatic aggregates of squamous and non-squamous NSCLC types were similarly distributed and were mainly detected in the resection samples (fig. 9A and 9B). Importantly, tumors with high CD79A gene expression were highly correlated with the presence of TLS (fig. 9C).
Although approximately equal numbers of TLS were detected in tumors of both treatment groups, TLS-positive patients treated with atuzumab showed an association with OS benefit, which was not observed in TLS-positive patients treated with docetaxel in the POPLAR (fig. 3E) and OAK studies (fig. 9F).
To further confirm that these Structures identified by H & E staining are indeed TLS, a subset of the samples were subjected to IHC to detect specific vasculature or High Endothelial Venules (HEV) known to associate with TLS and mediate lymphocyte trafficking to secondary Lymphoid organs (Colbeck, E.J. et al, therapeutic lymphoma Structures in Cancer: drivers of anticancer, immunosuppresion, or Bystandander Sentists in DisaseFront.8, 1830 (2017); engelhard, V.H. et al, immune Cell induction and therapeutic lymphoma Structures as Determinants of anticancer Immunity.J.200, 432-442 (2018)). The MECA-79 monoclonal antibody recognizes peripheral lymph node addressen (PNAd) by targeting CD62L or L-selectin expressed exclusively by HEV. Tumor samples from TLS positive patients were positive for MECA-79, CD40 and CD8 by IHC staining (FIGS. 4A to 4D).
TLS gene signature associated with Attuzumab OS benefit
As described above, by H&E TLS analysis was performed on a limited number (n = 290) of samples. To extend this analysis to the larger gene expression dataset we have available, previously reported TLS gene signatures were used. Confirmation based on H&The TLS sample of E was associated with the published TLS gene expression profiles (FIG. 9E), and also with the B-cell gene profile and T eff Gene signature correlated with expected results (FIGS. 9C and 9D) (Zhu, G. Et al, tumor-Associated temporal identification Structures: gene-Expression Profiling and Their bioengineering. Front. Immunological.8, 767 (2017); colbeck, E.J. et al, temporal localization Structures in Cancer: drivers of anti-Tumor Immunity, or Bystander Senttinels in DisaseFront.Immunol.8, 1830 (2017), bremenes, R.M. et al, the Role of Tumor-embedding pathologies in Development, progress, and progress of Non-Cell luminescence cancer.J. third organic. Oncol.11,789-800 (2016; german, C. Et al, presence of B Cell in Tertiary localization Structures with a property of a tissue in Cancer J.2014.2014.42, mass. C. Et al, presence of B Cell in Tertiary localization Structures in Cancer with a property of tissue J.Oncol.2014.2014.2014).
Patient tumors with high TLS gene signature were significantly correlated with OS benefit in the atlizumab treatment group in POPLAR (greater than median, HR =0.48, ci =0.27-0.86, p = 0.013) and in the oatlizumab treatment group in OAK (greater than median, HR =0.82, ci =0.64-1.06, p = 0.14) (fig. 5A and 5B). Similarly, using another TLS-associated gene signature identified by Cabrita et al, the hair-center initiation signature shows that treatment with atuzumab in POPLAR (greater than median, HR =0.44, ci =0.23-0.84, p = 0.013) and in OAK (greater than median, HR =0.66, ci =0.51-0.86, p = 0.01) showed significant survival benefits (fig. 5C and 5D) (Cabrita, r. Et al, terrial simple temporal structure improved survival methodology and survival efficiency in tumor 577,561-565 (2020)).
Plasma cell gene signature associated with astuzumab OS benefit
To further elucidate the B-cell subtypes present in tumors, several known B-cell characteristics were analyzed for their ability to predict survival (fig. 11A to 11C) (Newman, a.m. et al, robust expression of cell subsets from tissue expression profiles. Nat. Methods 12,453-457 (2015)). OS benefit treated with Attributumab shows one of the strongest associations with published Plasma Cell characteristics consisting of the double gene set TNFRSF17 (or BCMA) and the immunoglobulin junction region (IGJ or JCHAIN) common to all antibodies (Kroeger, D.R. et al, tumor-Infiltrating Plasma Cell array Associated with therapeutic approach Structures, cytolytic T-Cell Responses, and Superior Prognosis in Ovarian cancer. Clin. Cancer Res.22,3005-3015 (2016)). This high expression of the dual-gene plasma cell signature was closely correlated with OS benefit in OAKs with treatment with atuzumab (greater than median, HR =0.58, ci =0.44-0.74, p-straw 0.001) (fig. 6A).
Reduction of the Shannon Diversity Index (SDI) of the BCR (B cell receptor) lineage is associated with disease control
Given that plasma cell characteristics are highly correlated with clinical benefit, we wanted to investigate if there were any changes in BCR lineage or clonality following alemtuzumab treatment in patients exhibiting clinical benefit. 13 pairs of matched pre-and post-treatment biopsy samples from the alemtuzumab monotherapy treatment FIR (NCT 01846416) and BIRCH trials were analyzed as shown in fig. 6A to 6E. All post-treatment samples were taken at the time of disease progression. Median acquisition time was 184.5 days after initial treatment for patients with Partial Remission (PR) or patients with Stable Disease (SD); for patients with Progressive Disease (PD), median acquisition time was 51 days after initial treatment. The only PR patients analyzed here had a PFS of 12.9 months. 7 patients with SD and 5 patients with PD had median PFS of 5.52 months and 1.35 months, respectively. Due to the deletion, neither group reaches the median OS. Tumor RNA was isolated and BCR gene was sequenced. RNA-based clonal lineage Sequencing enables us to determine isotypes and exclude signal dilutions of non-expressing B cells (Schalper, K.A. et al, neoadjuvant nivolumab modifications the Tumor immunity in responsive leukemia in. Nat.Med.25,470-476 (2019); smith, C.C. et al, using RNA Sequencing of the Characterise the Tumor immunity. Methods mol. Biol.2055,245-272 (2020)). Most BCRs sequenced were of the IgG isotype, not IgA or IgM, indicating that tumor infiltrating B cells were predominantly IgG + B cells (fig. 12A to 12F).
Once the BCR cDNA library is generated and sequencing is complete, the BCR lineage will be evaluated using SDI (a measure of B cell clonality) (Chaudhary, N. And Wesemann, D.R. analytical immunology reproduction. Front. Immunol.9,462 (2018); greiff, V. Et al. A Bioformatic frame for immunological specificity profiling purposes detection of immunological status. Genome. Med.7,49 (2015); kaplinky, J. Et al. Butyl esters of immunological specificity samples on samples. Nat.7, 81 (Comm. 1181187)). SDI of BCR sequences of pre-and post-alemtuzumab treatment pairs (n = 11) of NSCLC patient tumor samples were compared to pre-treatment tumor sample pairs (n = 3), where both samples were taken before treatment began as experimental controls. Paired samples taken from 3 patients before treatment with atezumab showed no change in SDI (fig. 6B). Among the patients analyzed for the pre-and post-alemtuzumab samples, 7 patients with SD and 1 patient with PR showed a significant decrease in the shannon index of the tumor after treatment compared to the pre-treatment samples (p =0.0078, fig. 6C). In contrast, the post-treatment index was not significantly changed in 5 patients with PD (p = 0.8125) (fig. 6D). These observations indicate that BCR diversity is reduced in this limited subset of patients who show clinical benefit (PR and SD) for atelizumab. This indicates that clonal expansion or enrichment of specific Ig + B cells occurs in tumors treated with astuzumab. 5 patients receiving alemtuzumab treatment showed no evidence of clonal enrichment during treatment (fig. 6E).
Discussion of the preferred embodiments
Our data indicate that infiltration of B cells (specifically surface Ig + B cells and plasma cells) into the tumor microenvironment is a key factor in determining OS benefit in NSCLC patients receiving treatment with atelizumab. Our data demonstrate that the presence of B cells and TLS at baseline determines the atelizumab-mediated OS benefit, and these results were validated in three large independent clinical trial cohorts (one phase 2 study [ n =193] and two phase 3 studies [ n =591 and 727], respectively).
In our study, gene expression analysis showed a strong association between B-Cell markers (memory Cells and Plasma Cells) and the survival benefit of alemtuzumab treatment (fig. 1A to 1C, fig. 2A to 2D, and fig. 11A to 11C), and includes the Plasma Cell gene characteristics of BCMA and IGJ genes (Kroeger, d.r. et al, tumor-profiling Plasma Cells electrode Associated with clinical laboratory Structures, cytolytic T-Cell Responses, and Superior Prognosis in Ovarian cancer. Clin. Cancer res.22,3005-3015 (2016)). Data from BCR sequencing showed a decrease in intratumoral B cell diversity using SDI in patients showing clinical benefit to atelizumab and indicated the presence of B cell clonal expansion.
Analysis showed that CD79+ B cells were associated with CD8 when visualized by immunofluorescence imaging + The close proximity of T cells provides support for the role of these cells as APCs.
In this study, a strong correlation between CD79A gene expression and the presence of TLS was observed, as determined by H & E staining. TLS in NSCLC is reported to be predominantly present in early-stage Squamous NSCLC patients (> 95%), with 50% of patients having no Germinal center (Silina, K. et al, germinal center determination of the cosmetic Relevance of clinical laboratory Structure and article affected by clinical society in Lung Squamous Cell Carcinoma. Cancer Res.78,1308-1320 (2018)). Analysis of metastatic NSCLC showed that the prevalence of TLS was about 30%, and another 30% of patients had lymphatic aggregates without germinal centers. Our analysis also showed the presence of TLS histologically and gene expression profiles showed significant correlation of OS after atuzumab treatment, suggesting that they may play an important role in PD1/PD-L1 blocking the sustained immune response of tumors.
Our data indicate that treatment with atelizumab involves both cytolytic and antibody-mediated humoral effector mechanisms, respectively by T eff And B cell mediation. This result was shown in the OAK study using a composite biomarker consisting of T effector 8-gene signature (tGE) and CD79A (OS HR less than the median relative to the median of the attlizumab arms) (HR =0.7, ci =0.55-0.91, p for the tGE in the attlizumab group relative to the less than median OS HR<0.01; for tGE + CD79A HR =0.65, ci =0.50-0.84, p<0.01 (FIGS. 13A to 13D) (Kowanetz, M. Et al, differential regulation of PD-L1 expression by immune and tumor cells in NSCLC and the response to treatment with atezolizumab (anti-PD-L1), proc. Natl. Acad. Sci. U.S. A115, E10119-E10126 (2018)). With respect to other alemtuzumab biomarkers, B cell characteristics correlated with an increase in PD-L1 on immune cells, likely reflecting an inflamed tumor microenvironment (fig. 10A to 10D). However, neither B-Cell nor TLS gene signature was associated with Tumor Mutation Burden (TMB) nor STK11 mutation (FIGS. 10A to 10D) (Gardara, D.R. et al, blood-based tumor mutation as a predictor of clinical findings in Non-Small-Cell Lung cancer peptides with interstitial colon tumor cells. Nat. Med.24,1441-1448 (2018); hellmann, M.D. et al, genomic Feature of Response Combination immunity in Patents with Advanced Non-Small-Lung cancer. Cancer Cell.33,843-852e (2018)).
Furthermore, our data show that the presence of B cells (especially plasma cells) within the tumor at baseline is a key factor in determining the OS benefit of NSCLC patients treated with atelizumab. To our knowledge, our data provide the first substantial evidence that the presence of plasma cells and the presence of organized lymphoid structures such as TLS at baseline are associated with astuzumab-mediated OS benefit, but not with chemotherapy-mediated OS benefit. To this end, transcriptomics data, including the largest public transcriptome NSCLC database (217 cases treated with CPI or chemotherapy and associated clinical outcomes), were analyzed according to two large independent randomized clinical trial cohorts (OAK, n =699; and POPLAR, n = 192).
In our study, gene expression analysis showed a strong correlation between B cell markers and OS benefit with atuzumab treatment. We used single cell analysis to derive and validate specific and robust gene signatures to reliably deconvolute follicular B cells, GC B cells and plasma cells from a large number of tumor transcriptomes. While each B cell subset has some correlation with the outcome, plasma cells appear to be the most important. This may indicate a productive local germinal center reaction in which mature plasma cells are the final product. These data are supported by similar significant clinical benefit for patients with histologically identified TLS or TLS-like structures. Taken together, these data indicate that in the case of tumors with high plasma cell infiltration, they are identified as tumors with TLS or TLS-like structures that, upon stimulation with CPI, provide sustained tumor control.
Interestingly, tumors with TLS or lymphoid aggregates accounted for approximately 30% of all NSCLC tumors analyzed and were rich in B/plasma cell characteristics. In our cohort, the presence of histologically-identified TLS was significantly associated with OS improvement following treatment with atuzumab, suggesting that they may play an important role in a sustained intratumoral immune response to PD- (L) 1 blockade. When we applied plasma cell characteristics to the TCGA NSCLC transcriptome that were not treated predominantly with CPI, it was found to be independent of overall survival, suggesting that plasma cell infiltration is not merely a prognosis for NSCLC. Overall, we show, in the context of two large randomized clinical trials against comparison of alemtuzumab to chemotherapy, that there is a strong predictive correlation between B/plasma cells and overall survival, which is unique to the mechanism of immunotherapy.
The mechanism by which B/plasma cells promote anti-tumor immunity is not known. Analysis showed that CD79+ B cells were in close proximity to CD8+ T cells when visualized by immunofluorescence imaging, providing support for the role of these cells as APCs. Class switching and memory B cells are enriched in tumors of CIT responders to melanoma and RCC, which may promote antigen presentation to major cytotoxic T cells.
Our analysis showed that there was a significant correlation between histologically defined TLS and B cell subset gene signatures, which clearly indicates a common underlying B cell biology, possibly including humoral immune responses contributing to the overall response to atuzumab. Our findings also clearly indicate that increased frequency of B and plasma cells at baseline correlates with improved clinical outcome in NSCLC patients treated with atuzumab, regardless of cytotoxic T cell characteristics.
In summary, our analysis shows that there is a significant correlation between histologically defined TLS, B cell IHC, TLS and germinal center-related gene signatures, indicating a common underlying B cell biology, including humoral immune responses contributing to the atlizumab-mediated response. Our findings also indicate that more B-cells and plasma cells were independent of T-cells at baseline, improving clinical outcomes in NSCLC patients treated with atelizumab.
Materials and methods
Patient population
The study was performed using tissue samples from open, randomized phase 2 POLAR (NCT 01903993) and phase 3 OAK test (NCT 02008227) which evaluated alemtuzumab with docetaxel (Rittmeyer, A. Et al, atezolizumab docetaxel in patients with clinical progress after receiving platinum chemotherapy, alpha phase 3, open-label, multicentranjd controlled clinical. Lance 389,255-265 (2017); fenthrenher, L. Et al, atezolizu olyzumab supplement for clinical course non-smooth-cell (POL) in NSCLC patients who progressed on platinum chemotherapy domised controlled batch. Lancet 387,1837-1846 (2016)). Tissue-derived RNA from Phase 2 FIR (NCT 01846416) and BIRCH (NCT 02031458) singles panel trials evaluated Abelmoschus mab (Peters, S. Et al Phase II Trial of Atzolizumab As First-Line or sublequent Therapy for Patients With Programmed Death-Ligand 1-Selected Advanced Non-Small-Cell-Lung Cancer (BIRCH). J.Clin. Oncol.35,2781-2789 (2017); spigel, D.R. et al, FIR: effect, saigy, and Biomarker of a Phase II Open-Label culture of PD-L1-L1731-Selected NSCLC.1748) in locally Advanced or metastatic NSCLCC Patients, were used, with reference. Patients in all trials received 1200mg of alemtuzumab IV (q 3 w) every 3 weeks until disease progression or loss of clinical benefit occurred, or 75mg/m 2 Docetaxel IV q3w until PD occurs. Both FIR and BIRCH reported an improvement in response rate relative to historical averages; POPLAR and OAK studies showed that ATTETRAUzumab resulted in a significant improvement in OS compared to docetaxel regardless of PD-L1 expression (Rittmeyer, A. Et al, atezolizumab versatil docetaxel in tissues with previous linear displacement cam (OAK): a phase 3, open-lag, multicentre random coupled cam. Lance 389,255-265 (2017); fehrenger, L. Et al, atezolizumab versatil docetaxel for tissues with previous linear displacement cam-non-linear displacement cam-cell cam (POPLAR PLAR): multiple, open-lag, 2linear displacement cam 1846, 1836). All studies were approved by an independent ethics committee for each participating site, and safety data was reviewed by an independent data monitoring committee. No crossover is allowed and the primary endpoint is the OS.
Analysis of Gene expression
For 192 patients in POPLAR, 699 patients in OAK, 137 patients in FIR and 591 patients in BIRCH trial, all transcriptome profiles used the TruSeq RNA Access technique
Figure BDA0003990674580002561
And (4) generating. Ratio of RNAseq reads to ribosomal RNA sequencesAnd then to remove ribosomal reads. The NCI Build 38 human reference genome was then used to align the remaining reads of GSNAP version 2013-10-10, where at most two mismatches per 75 base sequence were allowed (parameter:' -M2-N10-B2-i 1-N1-w 200000-E1-pairmax-rna = 200000-clip-overlap). Transcript annotations were based on the Ensembl gene database (77 th edition). To quantify gene expression levels, the number of reads mapped to each RefSeq gene exon was calculated in a chain-specific manner using the functionality provided by the R Software package Genomic Alignments (Bioconductor) (Mariatasan, S. Et al, TGFbeta epitopes though responses to PD-L1 block by conditioning to exclusion of T cells. Nature 554,544-548 (2018); lawrence, M. Et al, software for computing and modeling Genomic sequences. PLoS. Comp. Biol.9, e1003118 (2013)).
To determine the biology associated with the benefits of alemtuzumab OS, patients with a survival period of <6 months (n = 24) or >12 months (n = 43) were grouped (Fehrenbacher, L. et al, atazolizumab versus facetaxel for patients with a previous treated non-small-cell lung cancer (POPLAR): a multicentre, open-label, phase 2 randulated controlled clinical. Lancet 387,1837-1846 (2016)). Differentially expressed genes between these two groups were determined using the R software package limma (Bioconductor) which estimates gene expression changes using a modest T-test using an empirical bayesian approach (Mariathasan, s. Et al, TGFbeta attributes pathway response to PD-L1 block by conditioning to expression of T cells. Nature 554,544-548 (2018); rietch, m.e. et al, limma powers differential expression analysis for RNA-sequencing and micro-array agents. Nucleic Acids res 43, e47 (2015).
Inter-dependence of key B-cell and T-cell gene contributions on overall survival benefit was also assessed using Cox proportional hazards regression analysis, among other things. In addition, paired t-test was used as indicated.
Genetic characterization
The B cell characteristics tested here include a number of markers and their various associated genes for naive B cells, memory B cells and plasma cells (Newman, a.m. et al, robust Expression of cell subsets from tissue Expression profiles. Nat. Methods 12,453-457 (2015); bindea, G.et al, spatiometric dynamics of endogenous animal cells derived from the animal in human cancer 39,782-795 (2013); iglesia, M.D. et al, genomic B-cell signatures using mRNA-seq in properties with sub-type-specific break and over-type cancer, res.20,3818-3829 (2014); palm, C.D., diehn, M.J., alizadeh, A.A. and Brown, P.O.cell-type specific Gene Expression profile of leucocytes in human biological module, BMC.Genomics7,115 (2006); suzuki, A. Et al, investigation of molecular biological Expression for diagnosis and analysis of environmental biological Expression (BMC, 12, expression of organism), M.D. et al, genomic B-cell signatures using mRNA-seq. No. 2. M.S. 2. C.. Initial B cell gene signature: ABCB4, BCL7A, BEND5, BRAF, IL4R, LINC00921, MEP1A, MICAL3, NIPSNAP3B, PSG2, SELL, TCL1A, UGT1A8, ZNF286A; memory B cell gene signature: AIM2, ALOX5, CLCA3P, FAM65B, IFNA10, IL7, NPIPB15, SP140, TNFRSF13B, TRAF4, ZBTB32; plasma cell gene characteristics: ABCB9, AMPD1, ANGPT4, ATXN8OS, C11, CCr10, HIST1H2AE, HIST1H2BG, IGHE, KCNA3, KCNG2, LOC100130100, MAN1A1, MANEA, MAST1, MROH7, MZB1, PAX7, PDK1, RASGRP3, REN, SPAG4, ST6GALNAC4, TGM5, UGT2B17, ZBP1, ZNF165; TLS Gene characterization as described in the review by Zhu et al (Zhu, G. Et al, tumor-Associated Tertiary lymphoma Structures: gene-Expression Profiling and the ir bioengineering. Front. Immunological.8, 767 (2017)): CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, CXCL13; b cell gene signature from this study: CD79A, SLAMF7, BTK, TNFRSF17 or BCMA, IGJ or JCHAIN, IGLL5, RBPJ, MZB1; and T cell effector gene characteristics: CD8A, EOMES, GZMA, TBX21, IFNG, GZMB, CXCL9, CXCL10 (Fehrenbacher, L. Et al, atezolizumab versals docetaxel for tasks with previous linear derived non-small-cell lung cancer (POPLAR): a multicentre, open-label, phase 2random controlled trial. Lancet 387,1837-1846 (2016)).
scRNAseq treatment and population specific characterization
Samples obtained from Gene Expression Omnibus (GEO) under accession number GSE131907 were counted as raw UMI per cell. In addition, the cell type and sample source annotation for each cell was also retrieved. These cell type annotations from the authors were used to isolate B cells from tumor and normal adjacent tissues and drain lymph nodes from the expression matrix. The Seurat software package (v3.1.4) was used for downstream analysis of B cells in R (3.6.2). Cells with more than 10% of fewer than 500 observed genes or mitochondrial reads were screened and the expression counts of the remaining cells were normalized to log (CPM/100 + 1). Principal component analysis was performed on the 2000 most variable genes and the first 30 principal components were used for UMAP dimensionality reduction and graph-based clustering. Clustering was determined using a resolution of 0.3. Markers for each cluster were detected by comparing all cells of the particular cluster to the rest of the cells in the dataset using Wilcoxon rank-sum test adjusted for multiple tests by Benjamini Hochberg method. non-B cell contaminating clusters (CD 3+ T cells, GZMB + LILRA4+ pDC, and HBA2+ erythrocytes) were removed from the initial dataset. After removal of these contaminating cells, the variable gene assay, PCA and UMAP dimensionality reduction were rerun using the parameters described above. Markers for each B cell subpopulation were identified as genes with adjusted p-values <0.001 and logFC >0.5, and B cells in the clusters were compared to all other cells in the dataset. To ensure B cell-specific expression of the marker, marker genes that are not expressed by B cells (including stromal cells, tumors, and non-B cell immune cells) in the complete data set (mean log (CPM/100 + 1) <1 in the non-B cell population) are further retained. Heatmaps for visual comparison were created using the pheatmap R software package (1.0.12).
CyTOF sample collection, staining and data processing
Six fresh NSCLC tumor samples were purchased from commercial suppliers (Discovery Life Sciences), which are part of adult patients undergoing surgical resection. After overnight fixation, cells were consumed in 3mL portions
Figure BDA0003990674580002581
Cell staining buffer washesAnd centrifuged at 800x g for 5 minutes. After aspiration of the wash buffer and resuspension of the cell pellet, 4mL was used
Figure BDA0003990674580002591
Water (Fluidigm) was used for another round of washing. Resuspend cells in 1mL
Figure BDA0003990674580002592
Water and counted. After obtaining a cell count, 3mL of the solution was added
Figure BDA0003990674580002593
Water, finally precipitating the cells once, and then performing instrumental collection. In the introduction of Helios TM Before, use
Figure BDA0003990674580002594
System (Fluidigm) resuspend pelleted cells in the medium containing EQ TM 1X of four element calibration bead (Fluidigm)
Figure BDA0003990674580002595
In water, filtration was then carried out using a 12X 75mm tube with a 35 μm nylon mesh cell filter cap (Corning). All FCS files are used
Figure BDA0003990674580002596
(MathWorks) normalization functions are normalized together and used
Figure BDA0003990674580002597
The software (FlowJo, LLC, ashland, oregon) performed the analysis. Protein marker expression intensities from mass cytometry analysis were aggregated from multiple samples and transformed using an inverse hyperbolic sine function. Applying dimensionality reduction to the transformed expression matrix using a Unified Manifold Approximation and Projection (UMAP) package with the following default parameters: min _ dist:0.1, n _ neighbors:15, n _ components:2, and metric: euclidean. In both the CD45+ and CD8+ populations, a single sample was downsampled to 8,000 cells per sample. Attach UMAP coordinates behind the ". Fcs" file as hands for use in connection with FlowJo (LLC) Dynamic gating analysis integrated additional channels.
Immunofluorescence and tertiary lymphoid analysis
Triple immunofluorescence (CD 8/CD 79/Ki-67) analysis was performed on 4 μm sections of Formalin Fixed Paraffin Embedded (FFPE) tumor samples, followed by deparaffinization, rehydration and epitope repair with antigen repair solution pH 6 at 99 ℃ for 20 minutes. Each round of staining began with quenching in 3% hydrogen peroxide. Sections were incubated in anti-CD 79a rabbit monoclonal antibody (SP 18) (Thermo Fischer Scientific, MA 5-14556) diluted in 1. Elution was carried out in antigen retrieval solution preheated to 99 ℃ for 20 minutes. Sections were incubated in anti-CD 8 mouse monoclonal antibody C8/144B (Dako, M7103) diluted to 1.5. Mu.g/ml, detected with PowerVision polyHRP anti-mouse antibody, and amplified with Alexa-Fluor 647 tyramide. After the elution step, sections were incubated in anti-Ki 67 mouse monoclonal antibody (MIB-1) (Dako, M7240) diluted to 1 μ g/ml, detected with PowerVision poly-HRP anti-mouse antibody, and amplified with Alexa-Fluor 555 tyramide. Slides were counterstained with 4', 6-diamidino-2-phenylindole (DAPI). Images of the fluorescent slides were collected on a NanoZoomer XR.
TLS was identified using H & E stained FFPE sections and examined by a pathologist (HK) to identify lymphatic aggregates similar to TLS. TLS is defined as those regions with well-defined boundaries that are morphologically similar to lymph aggregates (Dieu-Nosjean, M.C. et al, tele-physiology structures in cancer and beyond, trends immunol.35,571-580 (2014)). Representative slides were selected for IHC using MECA-79 in combination with peripheral lymph node addressin.
BCR lineage analysis
Of the 32 tumor samples, 16 (9 from BIRCH and 7 from FIR) were collected from NSCLC patients receiving treatment with Attemplumab (Tan, P. Et al, regulatory role of the CXCL13-CXCR5 axis in the tumor micro environmental, precision in clin. Med.1,49-56 (2018); bruno T.C.evaluating the anticancer role of the B cells in tissues with non-small cell lung cancer. J.clin. Oncol.35,75 (2017)). RNA was extracted from FFPE tumors using a high purity FFPE RNA isolation kit (roche). The BCR cDNA library was generated using the Immunoverse IgH kit (ArcherDX, inc., boulder, CO). The library was quantified using a KAPA Universal library quantification kit (KAPA Biosystems, wilmington, mass.). The libraries were combined at equimolar concentrations and sequenced using MiSeq kit v3 (600 cycles) and Illumina MiSeq instrument (Illumina, inc. By using
Figure BDA0003990674580002601
The analysis software analyzed the sequence data to calculate the SDI for each library (Greiff, V. et al, A bioinformatic frame for immune response sensitivity development of immune status. Genome Med.7,49 (2015); kaplinsky, J. et al, road tests of immune response sensitivity from high-throughput memories on samples. Nat. Commun.7,11881 (2016)). Statistical analysis of SDI between pairs of samples from the same patient was performed using Wilcoxon paired signed rank sum test and variation in SDI before/after treatment was compared between different patient groups using the Mann Whitney test.
Other examples
Although the foregoing invention has been described in some detail by way of illustration and embodiments for purposes of clarity of understanding, these descriptions and embodiments should not be construed as limiting the scope of the invention. The disclosures of all patent and scientific literature cited herein are expressly incorporated by reference in their entirety.
Exemplary embodiments of the present invention include those enumerated below.
1. A method of identifying an individual having cancer who is likely to benefit from treatment with a binding antagonist comprising a PD-L1 axis, the method comprising determining the expression levels of two or more of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ and MZB1 in a sample from the individual, wherein the individual is identified as an individual who is likely to benefit from treatment with a binding antagonist comprising a PD-L1 axis if the immune score expression levels of the two or more genes are greater than the reference immune score expression levels of the two or more genes.
2. A method of selecting a therapy for an individual having cancer, the method comprising determining the expression levels of two or more of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ and MZB1 in a sample from the individual, wherein the individual is identified as an individual likely to benefit from treatment comprising a PD-L1 axis binding antagonist if the immune score expression levels of the two or more genes are greater than the reference immune score expression levels of the two or more genes.
3. The method of example 1 or 2, wherein the immune score expression level of two or more genes in the sample is greater than the reference immune score expression level, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist.
4. A method of treating an individual having cancer, the method comprising:
(a) Determining the expression level of two or more of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual, wherein the determination that the immune score expression level of the two or more genes in the sample is higher than the reference immune score expression level of the two or more genes; and
(b) Administering to the individual an effective amount of a PD-L1 axis binding antagonist.
5. A method of treating cancer in an individual, wherein the individual has been determined to have in a sample from the individual an immune score expression level for two or more of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ and MZB1 that is greater than a reference immune score expression level for the two or more genes, the method comprising administering to the individual an effective amount of a PD-L1 axis binding antagonist.
6. The method of any one of embodiments 1 to 5, wherein the immune score reference expression level is an immune score expression level of two or more genes in a reference population.
7. The method of embodiment 6, wherein the reference population is a population of individuals having cancer.
8. The method of embodiment 7, wherein the population of individuals comprises a first subset of individuals who have received treatment with a PD-L1 axis binding antagonist and a second subset of individuals who have received treatment with a therapy that does not contain a PD-L1 axis binding antagonist.
9. The method of embodiment 8, wherein the reference immune score expression level visibly differentiates each of the first subset of individuals from the second subset of individuals based on a significant difference between the individual's responsiveness to treatment with the PD-L1 axis binding antagonist and the individual's responsiveness to treatment with the therapy without the PD-L1 axis binding antagonist that is greater than the reference immune score expression level, wherein the individual's responsiveness to treatment with the PD-L1 axis binding antagonist is significantly improved relative to the individual's responsiveness to treatment with the therapy without the PD-L1 axis binding antagonist.
10. The method of embodiment 8 or 9, wherein the therapy without the PD-L1 axis binding antagonist comprises an anti-tumor agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, or a combination thereof.
11. The method of embodiment 10, wherein the therapy without the PD-L1 axis binding antagonist comprises a chemotherapeutic agent.
12. The method of embodiment 11, wherein the chemotherapeutic agent is docetaxel.
13. The method of any one of embodiments 9 to 12, wherein responsiveness to treatment comprises prolongation of OS, prolongation of Progression Free Survival (PFS), or an increase in determined best overall response (BCOR).
14. The method of embodiment 13, wherein responsiveness to treatment comprises prolongation of OS.
15. The method of any one of embodiments 6-14, wherein the reference immune score expression level is the median of the expression levels of each of the two or more genes in the reference population.
16. The method of any one of embodiments 1-15, wherein genes comprise three or more of CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB 1.
17. The method of any one of embodiments 1-16, wherein genes comprise four or more of CD79A, CD19, BANK1, jchan, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB 1.
18. The method of any one of embodiments 1-17, wherein genes comprise five or more of CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1.
19. The method of any one of embodiments 1-18, wherein genes comprise six or more of CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1.
20. The method of any one of embodiments 1-19, wherein genes comprise seven, eight, nine, ten or more of CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1.
21. The method of any one of embodiments 1-20, wherein genes comprise CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1.
22. A method of identifying an individual having cancer who is likely to benefit from treatment with a PD-L1 axis binding antagonist, the method comprising determining the expression level of one or more of the genes CD79A, CD19, BANK1, jchanin, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual, wherein the benefit comprises an increase in the overall phase (OS) of the individual as compared to treatment without the PD-L1 axis binding antagonist if the immune score expression level of the one or more genes is greater than a reference immune score expression level for the one or more genes.
23. A method of selecting a therapy for an individual having cancer, the method comprising determining the expression level of one or more of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual, wherein in the event that the immune score expression level of the one or more genes is greater than a reference immune score expression level for the one or more genes, identifying the individual as an individual who is likely to benefit from treatment with a PD-L1 axis binding antagonist, wherein the benefit comprises an increase in OS in the individual as compared to treatment without the PD-L1 axis binding antagonist.
24. The method of embodiment 22 or 23, wherein the immune score expression level of one or more genes in the sample is greater than the reference immune score expression level, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist.
25. A method of treating an individual having cancer, the method comprising:
(a) Determining the expression level of one or more of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual, wherein determining the immune score expression level of the one or more genes in the sample is greater than a reference immune score expression level for the one or more genes identifies the individual as likely to benefit from treatment with a PD-L1 axis binding antagonist, wherein the benefit comprises a prolongation of OS in the individual as compared to treatment without the PD-L1 axis binding antagonist; and
(b) Administering to the individual an effective amount of a PD-L1 axis binding antagonist.
26. A method of treating cancer in an individual, wherein the individual has been determined to have an immune score expression level of one or more of the genes CD79A, CD19, BANK1, jchan, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual that is greater than a reference immune score expression level of the one or more genes, the method comprising administering to the individual an effective amount of a PD-L1 axis binding antagonist, wherein in the event the immune score expression level of the one or more genes is greater than the reference immune score expression level of the one or more genes, identifying the individual as an individual likely to benefit from treatment comprising a PD-L1 axis binding antagonist, wherein the benefit comprises an extended OS in the individual as compared to treatment without the PD-L1 axis binding antagonist.
27. The method of any one of embodiments 22-26, wherein the immune score expression level of one of genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 is determined.
28. The method of embodiment 27, wherein the immune score expression level of CD79A is determined.
29. The method of any one of embodiments 22 to 28, wherein the immune score reference expression level is an immune score expression level of one or more genes in a reference population.
30. The method of embodiment 29, wherein the reference population is a population of individuals with cancer.
31. The method of embodiment 30, wherein the population of individuals comprises a first subset of individuals who have received treatment with a PD-L1 axis binding antagonist and a second subset of individuals who have received treatment with a therapy that does not contain a PD-L1 axis binding antagonist.
32. The method of embodiment 31, wherein the immune score reference expression level visibly distinguishes between the first subset of individuals and each of the second subset of individuals based on a significant difference between the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist and the responsiveness of the individual to treatment with the therapy without the PD-L1 axis binding antagonist that is greater than the reference immune score expression level, wherein the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist is significantly improved relative to the responsiveness of the individual to treatment with the therapy without the PD-L1 axis binding antagonist.
33. The method of embodiment 31 or 32, wherein the therapy without the PD-L1 axis binding antagonist comprises an anti-neoplastic agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, or a combination thereof.
34. The method of embodiment 33, wherein the therapy without the PD-L1 axis binding antagonist comprises a chemotherapeutic agent.
35. The method of embodiment 34, wherein the chemotherapeutic agent is docetaxel.
36. The method of any one of embodiments 32-35, wherein responsiveness to treatment comprises prolongation of OS, prolongation of PFS, or an increase in BCOR.
37. The method of embodiment 36, wherein responsiveness to treatment is an extension of Overall Survival (OS).
38. The method of any one of embodiments 29 to 37, wherein the immune score reference expression level is the median of the expression levels of each of the one or more genes in the reference population.
39. The method of embodiment 38, wherein the median expression level is the median of the average Z-scores of the expression levels of each of the two or more genes in the reference population.
40. The method of any one of embodiments 22-39, wherein genes comprise two or more of CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB 1.
41. The method of any one of embodiments 1-5 and 40, wherein the two or more genes comprise TNFRSF17 and IGJ.
42. The method according to any one of embodiments 1-5 and 41, wherein the two genes consist of TNFRSF17 and IGJ.
43. The method of any one of embodiments 22-41, wherein genes comprise three or more of CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB 1.
44. The method of any one of embodiments 22-41-43, wherein genes comprise four or more of CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB 1.
45. The method of any one of embodiments 22-41, 43 and 44, wherein the genes comprise five or more of CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB 1.
46. The method of any one of embodiments 22-41 and embodiments 43-45, wherein genes comprise six or more of CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB 1.
47. The method of any one of embodiments 22-41 and embodiments 43-46, wherein the genes comprise seven, eight, nine, ten or more of CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB 1.
48. The method of any one of embodiments 22-41 and 43-47, wherein the genes comprise CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1.
49. The method of embodiment 48, wherein the gene consists of CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1.
50. A method of identifying an individual having cancer who is likely to benefit from treatment with a PD-L1 axis binding antagonist, the method comprising determining the expression level of one or more of the genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7 and IGLL5 in a sample from the individual, wherein the individual is identified as an individual who is likely to benefit from treatment with a PD-L1 axis binding antagonist if the immune score expression level of the one or more genes is higher than a reference immune score expression level of the one or more genes.
51. A method of selecting a therapy for an individual having cancer, the method comprising determining the expression level of one or more of the genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7 and IGLL5 in a sample from the individual, wherein the individual is identified as an individual likely to benefit from treatment comprising a PD-L1 axis binding antagonist if the immune score expression level of the one or more genes is higher than the reference immune score expression level of the one or more genes.
52. The method of embodiment 50 or 51, wherein the immune score expression level of one or more genes in the sample is greater than the reference immune score expression level, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist.
53. A method of treating a subject having cancer, the method comprising:
(a) Determining in a sample from the individual the expression level of one or more of the genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5, wherein the immune score expression level of the one or more genes in the sample is determined to be higher than a reference immune score expression level of the one or more genes; and
(b) Administering to the individual an effective amount of a PD-L1 axis binding antagonist.
54. A method of treating cancer in an individual, wherein the individual has been determined to have an immune score expression level of one or more of the genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 in a sample from the individual that is higher than a reference immune score expression level for the one or more genes, the method comprising administering to the individual an effective amount of a PD-L1 axis binding antagonist.
55. The method of any one of embodiments 50 to 54, wherein the immune score reference expression level is the immune score expression level of one or more genes in a reference population.
56. The method of embodiment 55, wherein the reference population is a population of individuals with cancer.
57. The method of embodiment 56, wherein the population of individuals comprises a first subset of individuals who have received treatment with a PD-L1 axis binding antagonist and a second subset of individuals who have received treatment with a therapy that does not contain a PD-L1 axis binding antagonist.
58. The method of embodiment 57, wherein the reference immune score expression level visibly differentiates each of the first subset of individuals from the second subset of individuals based on a significant difference between the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist and the responsiveness of the individual to treatment with the therapy without the PD-L1 axis binding antagonist that is greater than the reference immune score expression level, wherein the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist is significantly improved relative to the responsiveness of the individual to treatment with the therapy without the PD-L1 axis binding antagonist.
59. The method of embodiment 57 or 58, wherein the therapy without the PD-L1 axis binding antagonist comprises an anti-neoplastic agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, or a combination thereof.
60. The method of embodiment 59, wherein the therapy without the PD-L1 axis binding antagonist comprises a chemotherapeutic agent.
61. The method of embodiment 60, wherein the chemotherapeutic agent is docetaxel.
62. The method of any one of embodiments 58 to 61, wherein responsiveness to treatment comprises prolongation of OS, prolongation of PFS, or an increase in BCOR.
63. The method of embodiment 62, wherein responsiveness to treatment is an extension of Overall Survival (OS).
64. The method of any one of embodiments 55 to 63, wherein the reference immune score expression level is the median of the expression levels of each of the one or more genes in the reference population.
65. The method of any one of embodiments 50-64, wherein genes comprise two or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
66. The method of any one of embodiments 50-65, wherein genes comprise three or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
67. The method of any one of embodiments 50-66, wherein genes comprise four or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
68. The method of any one of embodiments 50-67, wherein genes comprise five or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
69. The method of any one of embodiments 50-68, wherein genes comprise six or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
70. The method of any one of embodiments 50-69, wherein genes comprise seven or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
71. The method of any one of embodiments 50-70, wherein genes comprise eight or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
72. The method of any one of embodiments 50-71, wherein the genes comprise nine or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
73. The method of any one of embodiments 50-72, wherein the genes comprise 10 or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
74. The method of any one of embodiments 50-73, wherein genes comprise 11 or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
75. The method of any one of embodiments 50-74, wherein genes comprise 12 or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
76. The method of any one of embodiments 50-75, wherein genes comprise 13 or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
77. The method of any one of embodiments 50-76, wherein genes comprise MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5.
78. A method of identifying an individual having cancer who is likely to benefit from treatment with a PD-L1 axis binding antagonist, the method comprising determining the expression level of one or more of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7 and IGLL5 in a sample from the individual, wherein the individual is identified as an individual who is likely to benefit from treatment with the PD-L1 axis binding antagonist if the immune score expression level of the one or more genes is greater than a reference immune score expression level for the one or more genes, wherein the benefit comprises an extension of the OS of the individual as compared to treatment without the PD-L1 axis binding antagonist.
79. A method of selecting a therapy for an individual having cancer, the method comprising determining the expression level of one or more of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 in a sample from the individual, wherein the individual is identified as an individual likely to comprise a treatment with a PD-L1 axis binding antagonist if the immune score expression level of the one or more genes is greater than a reference immune score expression level for the one or more genes, wherein the benefit comprises a prolonged OS for the individual as compared to treatment without the PD-L1 axis binding antagonist.
80. The method of embodiment 78 or 79, wherein the immune score expression level of one or more genes in the sample is greater than the reference immune score expression level, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist.
81. A method of treating an individual having cancer, the method comprising:
(a) Determining in a sample from the individual the expression level of one or more of the genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5, wherein determining the immune score expression level of the one or more genes in the sample is higher than a reference immune score expression level of the one or more genes, thereby identifying the individual as an individual who is likely to benefit from treatment comprising a PD-L1 axis binding antagonist, wherein the benefit comprises a prolongation of OS in the individual as compared to treatment without the PD-L1 axis binding antagonist; and
(b) Administering to the individual an effective amount of a PD-L1 axis binding antagonist.
82. A method of treating cancer in an individual, wherein the individual has been determined to have an immune score expression level of one or more of the genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7 and IGLL5 in a sample from the individual that is higher than a reference immune score expression level for the one or more genes, the method comprising administering to the individual an effective amount of a PD-L1 axis binding antagonist, wherein the individual is identified as an individual who is likely to comprise treatment with the PD-L1 axis binding antagonist, wherein the benefit comprises an extended OS in the individual as compared to treatment without the PD-L1 axis binding antagonist.
83. The method of any one of embodiments 78 to 82, wherein an immune score reference expression level is an immune score expression level of one or more genes in a reference population.
84. The method of embodiment 83, wherein the reference population is a population of individuals with cancer.
85. The method of embodiment 84, wherein the population of individuals comprises a first subset of individuals who have received treatment with a PD-L1 axis binding antagonist and a second subset of individuals who have received treatment with a therapy that does not contain a PD-L1 axis binding antagonist.
86. The method of embodiment 85, wherein the immune score reference expression level visibly distinguishes between the first subset of individuals and each of the second subset of individuals based on a significant difference between the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist and the responsiveness of the individual to treatment with the therapy without the PD-L1 axis binding antagonist that is greater than the reference immune score expression level, wherein the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist is significantly improved relative to the responsiveness of the individual to treatment with the therapy without the PD-L1 axis binding antagonist.
87. The method of embodiment 85 or 86, wherein the therapy without the PD-L1 axis binding antagonist comprises an anti-tumor agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, or a combination thereof.
88. The method of embodiment 87, wherein the therapy without the PD-L1 axis binding antagonist comprises a chemotherapeutic agent.
89. The method of embodiment 88, wherein the chemotherapeutic agent is docetaxel.
90. The method of any one of embodiments 86-89, wherein responsiveness to treatment comprises prolongation of OS, prolongation of PFS, or an increase in BCOR.
91. The method of embodiment 90, wherein responsiveness to treatment is an extension of Overall Survival (OS).
92. The method of any one of embodiments 83-91, wherein the immune score reference expression level is the median of the expression levels of each of the one or more genes in the reference population.
93. The method of embodiment 92, wherein the median expression level is the median of the average Z scores for the expression levels of each of the one or more genes in the reference population.
94. The method of any one of embodiments 78 to 93, wherein genes comprise two or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
95. The method of any one of embodiments 78 to 94, wherein genes comprise three or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
96. The method of any one of embodiments 78 to 95, wherein genes comprise four or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
97. The method of any one of embodiments 78 to 96, wherein genes comprise five or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
98. The method of any one of embodiments 78 to 97, wherein genes comprise six or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
99. The method of any one of embodiments 78 to 98, wherein genes comprise seven or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
100. The method of any one of embodiments 78 to 99, wherein genes comprise eight or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
101. The method of any one of embodiments 78 to 100, wherein genes comprise nine or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
102. The method of any one of embodiments 78 to 101, wherein genes comprise 10 or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
103. The method of any one of embodiments 78 to 102, wherein genes comprise 11 or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
104. The method of any one of embodiments 78 to 103, wherein genes comprise 12 or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
105. The method of any one of embodiments 78 to 104, wherein genes comprise 13 or more of MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL 5.
106. The method of any one of embodiments 78 to 105, wherein genes comprise MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5.
107. A method of identifying an individual having cancer who is likely to benefit from treatment comprising a PD-L1 axis binding antagonist, the method comprising determining the presence of Tertiary Lymphoid Structure (TLS) in a tumor sample from the individual, wherein the presence of TLS in the tumor sample identifies the individual as an individual who is likely to benefit from treatment comprising a PD-L1 axis binding antagonist.
108. A method of selecting a therapy for an individual having cancer, the method comprising determining the presence of TLS in a tumor sample from the individual, wherein the presence of TLS in the tumor sample identifies the individual as an individual who is likely to benefit from treatment comprising a PD-L1 axis binding antagonist.
109. The method of embodiment 107 or 108, wherein the presence of TLS is determined in a sample from the individual, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist.
110. A method of treating an individual having cancer, the method comprising:
(a) Determining the presence of TLS in a tumor sample from the individual; and
(b) Administering to the individual an effective amount of a PD-L1 axis binding antagonist.
111. A method of treating cancer in an individual, wherein the individual has been determined to have TLS present in a tumor sample from the individual, comprising administering to the individual an effective amount of a PD-L1 axis binding antagonist.
112. The method of any one of embodiments 107 to 111, wherein the presence of TLS is determined by histological staining, immunohistochemistry (IHC), immunofluorescence, or gene expression analysis.
113. The method of embodiment 112, wherein the histological staining comprises hematoxylin and eosin (H & E) staining.
114. The method of embodiment 112, wherein IHC or immunofluorescence comprises detecting CD62L, L-selectin, CD40 or CD8.
115. The method of embodiment 114, wherein the CD62L or L-selectin is detected using a MECA-79 antibody.
116. The method of embodiment 112, wherein the gene expression analysis comprises determining the expression level of a TLS gene signature in the sample.
117. The method of embodiment 116, wherein a TLS gene characteristic comprises one or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13.
118. The method of embodiment 117, wherein the genes comprise two or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13.
119. A method of identifying an individual having cancer who is likely to benefit from treatment comprising a PD-L1 axis binding antagonist, the method comprising determining the expression level of two or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from the individual, wherein the individual is identified as an individual who is likely to benefit from treatment comprising a PD-L1 axis binding antagonist if the immune score expression level of the two or more genes is greater than a reference immune score expression level of the two or more genes.
120. A method of selecting a therapy for an individual having a cancer, the method comprising determining the expression level of two or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from the individual, wherein the individual is identified as an individual likely to benefit from treatment comprising a PD-L1 axis binding antagonist if the immune score expression level of the two or more genes is greater than a reference immune score expression level of the two or more genes.
121. The method of embodiment 119 or 120, wherein the immune score expression level of five or more genes in the sample is greater than the reference immune score expression level, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist.
122. A method of treating an individual having cancer, the method comprising:
(a) Determining the expression level of two or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from the individual, wherein determining the immune score expression level of the two or more genes in the sample is higher than a reference immune score expression level of the two or more genes; and
(b) Administering to the individual an effective amount of a PD-L1 axis binding antagonist.
123. A method of treating cancer in an individual, wherein the individual has been determined to have an immune score expression level of two or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from the individual that is higher than a reference immune score expression level of the two or more genes, the method comprising administering to the individual an effective amount of a PD-L1 axis binding antagonist.
124. The method of any one of embodiments 119-123, wherein the reference immune score expression level is an immune score expression level of two or more genes in a reference population.
125. The method of embodiment 124, wherein the reference population is a population of individuals with cancer.
126. The method of embodiment 125, wherein the population of individuals comprises a first subset of individuals who have received treatment with a PD-L1 axis binding antagonist and a second subset of individuals who have received treatment with a therapy that does not contain a PD-L1 axis binding antagonist.
127. The method of embodiment 126, wherein the reference immune score expression level visibly distinguishes each of the first subset of individuals from the second subset of individuals based on a significant difference between the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist and the responsiveness of the individual to treatment with the therapy without the PD-L1 axis binding antagonist above the reference expression level, wherein the responsiveness of the individual to treatment with the PD-L1 axis binding antagonist is significantly improved relative to the responsiveness of the individual to treatment with the therapy without the PD-L1 axis binding antagonist.
128. The method of embodiment 126 or 127, wherein the therapy without a PD-L1 axis binding antagonist comprises an anti-tumor agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, or a combination thereof.
129. The method of embodiment 128, wherein the therapy without the PD-L1 axis binding antagonist comprises a chemotherapeutic agent.
130. The method of embodiment 129, wherein the chemotherapeutic agent is docetaxel.
131. The method of any one of embodiments 127 to 130, wherein responsiveness to treatment comprises prolongation of OS, prolongation of PFS, or an increase in BCOR.
132. The method of embodiment 131, wherein responsiveness to treatment is an extension of Overall Survival (OS).
133. The method of any one of embodiments 125-132, wherein the reference immune score expression level is the median of the expression levels of each of the two or more genes in the reference population.
134. The method of embodiment 133, wherein the median expression level is the median of the average Z-scores of the expression levels of each of the two or more genes in the reference population.
135. The method of any one of embodiments 110-134, wherein the genes comprise three or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13.
136. The method of any one of embodiments 119-135, wherein a gene comprises four or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13.
137. The method of any one of embodiments 119-136, wherein a gene comprises five or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13.
138. The method of any one of embodiments 119-137, wherein the genes comprise six or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13.
139. The method of any one of embodiments 119-138, wherein genes comprise seven or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13.
140. The method of any one of embodiments 119-139, wherein genes comprise eight or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13.
141. The method of any one of embodiments 119-140, wherein genes comprise nine or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13.
142. The method of any one of embodiments 119-141, wherein genes comprise ten or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL 13.
143. The method of any one of embodiments 119-142, wherein a gene comprises eleven or more of CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13.
144. The method of any one of embodiments 119-143, wherein the gene comprises CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13.
145. The method of any one of embodiments 1-106 and 119-144, wherein the expression level is a nucleic acid expression level.
146. The method of embodiment 145, wherein the nucleic acid expression level is an mRNA expression level.
147. The method of embodiment 146, wherein mRNA expression levels are determined by RNA-seq, RT-qPCR, multiplex qPCR or RT-qPCR, microarray analysis, SAGE, massARRAY technology, FISH, or a combination thereof.
148. The method of embodiment 147, wherein mRNA expression levels are detected using RNA-seq.
149. The method of any one of embodiments 1 to 106 and 119 to 144, wherein the expression level is a protein expression level.
150. The method of embodiment 149, wherein the protein expression level is determined by IHC, immunofluorescence, mass spectrometry, flow cytometry, and western blot, or a combination thereof.
151. The method of any one of embodiments 1-106 and 119-150, wherein the expression level is detected in tumor cells, tumor infiltrating immune cells, stromal cells, paracancerous normal tissue (NAT) cells, or a combination thereof.
152. A method of identifying an individual having cancer who is likely to benefit from treatment with a binding antagonist comprising PD-L1 axis, the method comprising determining the number of B cells in a tumor sample from the individual, wherein in the event that the number of B cells in the tumor sample is greater than a reference number of B cells, identifying the individual as an individual who is likely to benefit from treatment with a binding antagonist comprising PD-L1 axis.
153. A method of selecting a therapy for an individual having cancer, the method comprising determining the number of B cells in a tumor sample from the individual, wherein in the event the number of B cells in the tumor sample is greater than a reference number of B cells, identifying the individual as an individual likely to benefit from treatment comprising a PD-L1 axis binding antagonist.
154. The method of embodiment 152 or 153, wherein the number of B cells in the sample is greater than the reference number, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist.
155. A method of treating an individual having cancer, the method comprising:
(a) Determining the number of B cells in a tumor sample from an individual; and
(b) Administering to the individual an effective amount of a PD-L1 axis binding antagonist.
156. A method of treating cancer in an individual, wherein the individual has been determined to have a number of B cells in a tumor sample from the individual that is greater than a reference number of B cells, comprising administering to the individual an effective amount of a PD-L1 axis binding antagonist.
157. The method of any one of embodiments 152-156, wherein B cells comprise CD79+ B cells, igG + B cells, and/or plasma cells.
158. The method of embodiment 157, wherein the B cells comprise plasma cells.
159. A method of identifying an individual having cancer who is likely to benefit from treatment comprising a PD-L1 axis binding antagonist, the method comprising determining whether the individual has clonally expanded B cells in a tumor sample from the individual, wherein the clonally expanded B cells in the sample identify the individual as an individual who is likely to benefit from treatment comprising a PD-L1 axis binding antagonist.
160. A method of selecting a therapy for an individual having cancer, the method comprising determining whether the individual has clonally expanded B cells in a tumor sample from the individual, wherein the clonally expanded B cells in the sample identify the individual as an individual likely to benefit from treatment comprising a PD-L1 axis binding antagonist.
161. The method of embodiment 159 or 160, wherein the tumor sample comprises clonally expanded B cells, and the method further comprises administering to the individual an effective amount of a PD-L1 axis binding antagonist.
162. A method of treating a subject having cancer, the method comprising:
(a) Determining that the individual has clonally expanded B cells in a tumor sample from the individual; and
(b) Administering to the individual an effective amount of a PD-L1 axis binding antagonist.
163. A method of treating cancer in an individual, wherein the individual has been determined to have clonally expanded B cells in a tumor sample from the individual, comprising administering to the individual an effective amount of a PD-L1 axis binding antagonist.
164. The method of any one of embodiments 159 to 163, wherein the clonally expanded B cells are clonally expanded plasma cells.
165. The method of any one of embodiments 159 to 164, wherein clonally expanded B cells are detected by measuring the diversity of B Cell Receptor (BCR) gene lineages in a tumor sample.
166. The method of embodiment 165, wherein in the event that a Shannon Diversity Index (SDI) of a BCR gene lineage in a tumor sample from the individual is lower than a reference SDI, identifying the individual as an individual likely to benefit from treatment comprising a PD-L1 axis binding antagonist.
167. The method of any one of embodiments 1-106 and embodiments 119-151, wherein the sample is a tissue sample, a cell sample, a whole blood sample, a plasma sample, a serum sample, or a combination thereof.
168. The method of embodiment 167, wherein the tissue sample is a tumor tissue sample.
169. The method of any one of embodiments 107-118 and embodiments 152-166, wherein the tumor sample is a tumor tissue sample.
170. The method of embodiment 168 or 169, wherein the tumor tissue sample comprises tumor cells, tumor infiltrating immune cells, stromal cells, NAT cells, or a combination thereof.
171. The method of any one of embodiments 168 to 170, wherein the tumor tissue sample is a Formalin Fixed and Paraffin Embedded (FFPE) sample, an archived sample, a fresh sample, or a frozen sample.
172. The method of embodiment 171, wherein the tumor tissue sample is an FFPE sample.
173. The method of any one of embodiments 1-172, wherein cancer is lung cancer, kidney cancer, bladder cancer, breast cancer, colorectal cancer, ovarian cancer, pancreatic cancer, stomach cancer, esophageal cancer, mesothelioma, melanoma, head and neck cancer, thyroid cancer, sarcoma, prostate cancer, glioblastoma, cervical cancer, thymus cancer, leukemia, lymphoma, myeloma, mycosis fungoides, merkel cell carcinoma, or hematological malignancy.
174. The method of embodiment 173, wherein the cancer is lung, kidney, bladder or breast cancer.
175. The method of embodiment 174, wherein the lung cancer is non-small cell lung cancer (NSCLC).
176. The method of embodiment 175, wherein the NSCLC is non-squamous NSCLC.
177. The method of embodiment 175, wherein the NSCLC is squamous NSCLC.
178. The method according to any one of examples 1-3, examples 6-52, examples 55-109, examples 112-121, examples 124-154, examples 157-161, and examples 164-177, wherein the benefit comprises prolongation of OS in the individual, prolongation of PFS in the individual, and/or improvement in BCOR in the individual as compared to treatment without the PD-L1 axis binding antagonist.
179. The method of embodiment 178, wherein the benefit comprises a prolongation of OS in the individual as compared to treatment without the PD-L1 axis binding antagonist.
180. The method of any one of embodiments 1 to 179, wherein the PD-L1 axis binding antagonist is selected from the group consisting of a PD-L1 binding antagonist, a PD-1 binding antagonist, and a PD-L2 binding antagonist.
181. The method of embodiment 180, wherein the PD-L1 axis binding antagonist is a PD-L1 binding antagonist.
182. The method of embodiment 181, wherein the PD-L1 binding antagonist inhibits the binding of PD-L1 to one or more of its ligand binding partners.
183. The method of embodiment 182, wherein the PD-L1 binding antagonist inhibits the binding of PD-L1 to PD-1.
184. The method of embodiment 182, wherein the PD-L1 binding antagonist inhibits the binding of PD-L1 to B7-1.
185. The method of any one of embodiments 182 to 184, wherein the PD-L1 binding antagonist inhibits the binding of PD-L1 to both PD-1 and B7-1.
186. The method of any one of embodiments 182 to 185, wherein the PD-L1 binding antagonist is an antibody or antigen-binding fragment thereof.
187. The method of embodiment 186, wherein the antibody is selected from the group consisting of: alemtuzumab, MDX-1105, MEDI4736 (devoluumab), and MSB0010718C (avizumab).
188. The method of embodiment 186, wherein the antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
189. The method of embodiment 186, wherein the antibody comprises: a heavy chain variable region comprising the amino acid sequence of SEQ ID NO 7; and a light chain variable region comprising the amino acid sequence of SEQ ID NO 8.
190. The method of embodiment 180, wherein the PD-L1 axis binding antagonist is a PD-1 binding antagonist.
191. The method of embodiment 190, wherein the PD-1 binding antagonist inhibits the binding of PD-1 to one or more of its ligand binding partners.
192. The method of embodiment 191, wherein the PD-1 binding antagonist inhibits the binding of PD-1 to PD-L1.
193. The method of embodiment 191, wherein the PD-1 binding antagonist inhibits the binding of PD-1 to PD-L2.
194. The method of any one of embodiments 191-193, wherein the PD-1 binding antagonist inhibits the binding of PD-1 to both PD-L1 and PD-L2.
195. The method of any one of embodiments 191 to 194, wherein the PD-1 binding antagonist is an antibody or antigen-binding fragment thereof.
196. The method of embodiment 195, wherein the antibody is selected from the group consisting of: MDX-1106 (nivolumab), MK-3475 (pembrolizumab), MEDI-0680 (AMP-514), PDR001, REGN2810, and BGB-108.
197. The method of any one of embodiments 190 to 194, wherein the PD-1 binding antagonist is an Fc fusion protein.
198. The method of embodiment 197, wherein the Fc fusion protein is AMP-224.
199. The method of any one of embodiments 1-198, wherein the subject has not been treated for the cancer.
200. The method of embodiment 199, wherein the individual has not been administered a PD-L1 axis binding antagonist.
201. The method of embodiment 199 or 200, wherein the cancer is NSCLC and the individual does not have EGFR or ALK genomic tumor aberrations.
202. The method of any one of embodiments 1-198, wherein the subject has been previously treated for the cancer.
203. The method of embodiment 202, wherein the individual has been treated for the cancer by administering to the individual a platinum-containing chemotherapeutic, and wherein the individual is non-responsive to the chemotherapeutic.
204. The method according to any one of embodiments 4 to 21, embodiments 25 to 48, embodiments 53 to 77, embodiments 81 to 106, embodiments 110 to 118, embodiments 122 to 151, embodiments 155 to 158 and embodiments 162 to 203, wherein the PD-L1 axis binding antagonist is administered as a monotherapy.
205. The method according to any one of embodiments 4 to 21, embodiments 25 to 48, embodiments 53 to 77, embodiments 81 to 106, embodiments 110 to 118, embodiments 122 to 151, embodiments 155 to 158 and embodiments 162 to 203, wherein the method further comprises administering an effective amount of one or more additional therapeutic agents.
206. The method of embodiment 205, wherein the one or more additional therapeutic agents comprise an anti-neoplastic agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, an immunomodulatory agent, or a combination thereof.
207. The method of any one of embodiments 1-206, wherein the subject is a human.
208. A kit comprising a PD-L1 axis binding antagonist and instructions for administering the PD-L1 axis binding antagonist to an individual who has been identified as an individual who is likely to benefit from treatment comprising the PD-L1 binding antagonist according to the method of any one of examples 1 to 3, examples 6 to 52, examples 55 to 109, examples 111 to 121, examples 124 to 154, examples 157 to 161, and examples 164 to 203.
209. A kit comprising a PD-L1 axis binding antagonist and instructions for administering the PD-L1 axis binding antagonist to an individual for whom treatment comprising the PD-L1 axis binding antagonist has been selected according to the method of any one of example 2, example 3, examples 6-21, example 23, examples 27-49, example 51, examples 55-77, example 79, examples 83-106, example 108, examples 112-118, example 120, examples 124-151, example 153, 154, 157, 158, 160, 161, and examples 164-203.
210. A kit for identifying an individual having cancer who is likely to benefit from treatment with a PD-L1 axis binding antagonist, the kit comprising reagents for determining the expression level of two or more of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual, wherein the individual is identified as an individual who is likely to benefit from treatment with a PD-L1 axis binding antagonist if the immune score expression level of the two or more genes is greater than a reference immune score expression level for the two or more genes.
211. A kit for identifying an individual having cancer who is likely to benefit from treatment with a PD-L1 axis binding antagonist, the kit comprising reagents for determining the expression level of one or more of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual, wherein the individual is identified as an individual who is likely to benefit from treatment with a PD-L1 axis binding antagonist where the immune score expression level of the one or more genes is greater than a reference immune score expression level for the one or more genes, wherein the benefit comprises an increase in the Overall Survival (OS) of the individual as compared to treatment without the PD-L1 axis binding antagonist.
212. A kit for identifying an individual having cancer who is likely to benefit from treatment with a PD-L1 axis binding antagonist, the kit comprising reagents for determining the expression level of one or more of the genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7 and IGLL5 in a sample from the individual, wherein the individual is identified as an individual who is likely to benefit from treatment with a PD-L1 axis binding antagonist if the immune score expression level of the one or more genes is greater than a reference immune score expression level for the one or more genes, wherein the benefit comprises an extended total survival (OS) of the individual as compared to treatment without the PD-L1 axis binding antagonist.
213. A kit for identifying an individual having cancer who is likely to benefit from treatment with a binding antagonist for the PD-L1 axis, the kit comprising reagents for determining the presence of a Tertiary Lymphoid Structure (TLS) in a tumor sample from the individual, wherein the presence of TLS in the tumor sample identifies the individual as an individual who is likely to benefit from treatment with a binding antagonist for the PD-L1 axis.
214. A kit for identifying an individual having cancer who is likely to benefit from treatment comprising a PD-L1 axis binding antagonist, the kit comprising reagents for determining the expression level of two or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from the individual, wherein the individual is identified as an individual who is likely to benefit from treatment comprising a PD-L1 axis binding antagonist if the immune score expression level of the two or more genes is higher than a reference immune score expression level of the two or more genes.
215. A kit for identifying an individual having cancer who is likely to benefit from treatment with a PD-L1 axis binding antagonist, the kit comprising reagents for determining the number of B cells in a tumor sample from the individual, wherein the individual is identified as an individual who is likely to benefit from treatment with a PD-L1 axis binding antagonist if the number of B cells in the tumor sample is higher than a reference number of B cells, optionally wherein the B cells comprise plasma cells.
216. A kit for identifying an individual having cancer who is likely to benefit from treatment with a PD-L1 axis binding antagonist, the kit comprising reagents for determining whether the individual has clonally expanded B cells in a tumor sample from the individual, wherein having clonally expanded B cells in the sample identifies the individual as an individual who is likely to benefit from treatment with a PD-L1 axis binding antagonist.
217. A PD-L1 axis binding antagonist for use in a method of treating an individual having cancer, the method comprising:
(a) Determining the expression level of two or more of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual, wherein the determination of the immune score expression level of the two or more genes in the sample is higher than a reference immune score expression level of the two or more genes; and
(b) Administering to the individual an effective amount of a PD-L1 axis binding antagonist.
218. A PD-L1 axis binding antagonist for use in treating cancer in an individual, wherein the individual has been determined to have an immune score expression level of two or more of the genes CD79A, CD19, BANK1, jcha in, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual that is greater than a reference immune score expression level for the two or more genes.
219. A PD-L1 axis binding antagonist for use in a method of treating an individual having cancer, the method comprising:
(a) Determining the expression level of one or more of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual, wherein determining the immune score expression level of the one or more genes in the sample is greater than a reference immune score expression level for the one or more genes identifies the individual as likely to benefit from treatment with a PD-L1 axis binding antagonist, wherein the benefit comprises a prolongation of OS in the individual as compared to treatment without the PD-L1 axis binding antagonist; and
(b) Administering to the individual an effective amount of a PD-L1 axis binding antagonist.
220. A PD-L1 axis binding antagonist for use in treating cancer in an individual, wherein the individual has been determined to have an immune score expression level of one or more of the genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual that is greater than a reference immune score expression level for the one or more genes, wherein the individual is identified as an individual likely to benefit from treatment with the PD-L1 axis binding antagonist, wherein the benefit comprises an increased OS in the individual as compared to treatment without the PD-L1 axis binding antagonist, if the immune score expression level of the one or more genes is greater than the reference immune score expression level for the one or more genes.
221. A PD-L1 axis binding antagonist for use in a method of treating an individual having cancer, the method comprising:
(a) Determining in a sample from the individual the expression level of one or more of the genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5, wherein the immune score expression level of the one or more genes in the sample is determined to be higher than a reference immune score expression level of the one or more genes; and
(b) Administering to the individual an effective amount of a PD-L1 axis binding antagonist.
222. A PD-L1 axis binding antagonist for use in treating cancer in an individual, wherein the individual has been determined to have an immune score expression level of one or more of the genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 in a sample from the individual that is higher than a reference immune score expression level of the one or more genes.
223. A PD-L1 axis binding antagonist for use in a method of treating an individual having cancer, the method comprising:
(a) Determining in a sample from the individual the expression level of one or more of the genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5, wherein determining the immune score expression level of the one or more genes in the sample is higher than a reference immune score expression level of the one or more genes, thereby identifying the individual as an individual who is likely to benefit from treatment comprising a PD-L1 axis binding antagonist, wherein the benefit comprises a prolongation of OS in the individual as compared to treatment without the PD-L1 axis binding antagonist; and
(b) Administering to the individual an effective amount of a PD-L1 axis binding antagonist.
224. A PD-L1 axis binding antagonist for use in treating cancer in an individual, wherein the individual has been determined to have in a sample from the individual an immune score expression level of one or more of the genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 that is higher than a reference immune score expression level for the one or more genes, wherein in the event that the immune score expression level of the one or more genes is higher than the reference immune score expression level for the one or more genes, identifying the individual as an individual likely to comprise treatment with the PD-L1 axis binding antagonist, wherein the benefit comprises an extension of the individual's OS as compared to treatment without the PD-L1 axis binding antagonist.
225. A PD-L1 axis binding antagonist for use in a method of treating an individual having cancer, the method comprising:
(a) Determining the presence of TLS in a tumor sample from the individual; and
(b) Administering to the individual an effective amount of a PD-L1 axis binding antagonist.
226. A PD-L1 axis binding antagonist for use in treating cancer in an individual, wherein the individual has been determined to have TLS present in a tumor sample from the individual.
227. A PD-L1 axis binding antagonist for use in a method of treating an individual having cancer, the method comprising:
(a) Determining the expression level of two or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from the individual, wherein determining the immune score expression level of the two or more genes in the sample is higher than a reference immune score expression level of the two or more genes; and
(b) Administering to the individual an effective amount of a PD-L1 axis binding antagonist.
228. A PD-L1 axis binding antagonist for use in treating a cancer in an individual, wherein the individual has been determined to have an immune score expression level of two or more of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from the individual that is higher than a reference immune score expression level of the two or more genes.
229. A PD-L1 axis binding antagonist for use in a method of treating an individual having cancer, the method comprising:
(a) Determining the number of B cells in a tumor sample from the individual, optionally wherein the B cells comprise plasma cells; and
(b) Administering to the individual an effective amount of a PD-L1 axis binding antagonist.
230. A PD-L1 axis binding antagonist for use in treating cancer in an individual, wherein the individual has been determined to have a number of B cells in a tumor sample from the individual that is higher than a reference number of B cells, optionally wherein the B cells comprise plasma cells.
231. A PD-L1 axis binding antagonist for use in a method of treating an individual having cancer, the method comprising:
(a) Determining that the individual has clonally expanded B cells in a tumor sample from the individual; and
(b) Administering to the individual an effective amount of a PD-L1 axis binding antagonist.
232. A PD-L1 axis binding antagonist for use in treating cancer in an individual, wherein the individual has been determined to have clonally expanded B cells in a tumor sample from the individual.
233. A kit according to any one of embodiments 208 to 216 or a PD-L1 axis binding antagonist for use according to any one of embodiments 217 to 232, wherein the PD-L1 axis binding antagonist is an anti-PD-L1 antagonist antibody, optionally wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain variable region comprising the amino acid sequence of SEQ ID NO 7; and a light chain variable region comprising the amino acid sequence of SEQ ID NO:8, optionally wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the amino acid sequence of SEQ ID NO 9; and a light chain comprising the amino acid sequence of SEQ ID NO:10, optionally wherein the anti-PD-L1 antagonist antibody is atezumab.
Sequence listing
<110> Gene Tak Co., ltd (Genentech, inc.)
<120> methods and compositions for cancer immunotherapy
<130> 50474-209WO2
<150> US 63/038,559
<151> 2020-06-12
<160> 83
<170> PatentIn version 3.5
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Gly Phe Thr Phe Ser Asp Ser Trp Ile His
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Ala Trp Ile Ser Pro Tyr Gly Gly Ser Thr Tyr Tyr Ala Asp Ser Val
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Lys Gly
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Arg His Trp Pro Gly Gly Phe Asp Tyr
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Arg Ala Ser Gln Asp Val Ser Thr Ala Val Ala
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Ser Ala Ser Phe Leu Tyr Ser
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Gln Gln Tyr Leu Tyr His Pro Ala Thr
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Ser Leu Arg Leu Ser Cys Ala Ala Ser Gly Phe Thr Phe Ser Asp Ser
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Trp Ile His Trp Val Arg Gln Ala Pro Gly Lys Gly Leu Glu Trp Val
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Ala Trp Ile Ser Pro Tyr Gly Gly Ser Thr Tyr Tyr Ala Asp Ser Val
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Lys Gly Arg Phe Thr Ile Ser Ala Asp Thr Ser Lys Asn Thr Ala Tyr
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Leu Gln Met Asn Ser Leu Arg Ala Glu Asp Thr Ala Val Tyr Tyr Cys
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Ala Arg Arg His Trp Pro Gly Gly Phe Asp Tyr Trp Gly Gln Gly Thr
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Leu Val Thr Val Ser Ser
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Asp Ile Gln Met Thr Gln Ser Pro Ser Ser Leu Ser Ala Ser Val Gly
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Asp Arg Val Thr Ile Thr Cys Arg Ala Ser Gln Asp Val Ser Thr Ala
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Val Ala Trp Tyr Gln Gln Lys Pro Gly Lys Ala Pro Lys Leu Leu Ile
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Tyr Ser Ala Ser Phe Leu Tyr Ser Gly Val Pro Ser Arg Phe Ser Gly
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Ser Gly Ser Gly Thr Asp Phe Thr Leu Thr Ile Ser Ser Leu Gln Pro
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Glu Asp Phe Ala Thr Tyr Tyr Cys Gln Gln Tyr Leu Tyr His Pro Ala
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Thr Phe Gly Gln Gly Thr Lys Val Glu Ile Lys Arg
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Glu Val Gln Leu Val Glu Ser Gly Gly Gly Leu Val Gln Pro Gly Gly
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Ser Leu Arg Leu Ser Cys Ala Ala Ser Gly Phe Thr Phe Ser Asp Ser
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Trp Ile His Trp Val Arg Gln Ala Pro Gly Lys Gly Leu Glu Trp Val
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Ala Trp Ile Ser Pro Tyr Gly Gly Ser Thr Tyr Tyr Ala Asp Ser Val
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Lys Gly Arg Phe Thr Ile Ser Ala Asp Thr Ser Lys Asn Thr Ala Tyr
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Leu Gln Met Asn Ser Leu Arg Ala Glu Asp Thr Ala Val Tyr Tyr Cys
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Ala Arg Arg His Trp Pro Gly Gly Phe Asp Tyr Trp Gly Gln Gly Thr
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Leu Val Thr Val Ser Ser Ala Ser Thr Lys Gly Pro Ser Val Phe Pro
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Leu Ala Pro Ser Ser Lys Ser Thr Ser Gly Gly Thr Ala Ala Leu Gly
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Cys Leu Val Lys Asp Tyr Phe Pro Glu Pro Val Thr Val Ser Trp Asn
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Ser Gly Ala Leu Thr Ser Gly Val His Thr Phe Pro Ala Val Leu Gln
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Ser Ser Gly Leu Tyr Ser Leu Ser Ser Val Val Thr Val Pro Ser Ser
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Ser Leu Gly Thr Gln Thr Tyr Ile Cys Asn Val Asn His Lys Pro Ser
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Asn Thr Lys Val Asp Lys Lys Val Glu Pro Lys Ser Cys Asp Lys Thr
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His Thr Cys Pro Pro Cys Pro Ala Pro Glu Leu Leu Gly Gly Pro Ser
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Val Phe Leu Phe Pro Pro Lys Pro Lys Asp Thr Leu Met Ile Ser Arg
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Thr Pro Glu Val Thr Cys Val Val Val Asp Val Ser His Glu Asp Pro
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Glu Val Lys Phe Asn Trp Tyr Val Asp Gly Val Glu Val His Asn Ala
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Lys Thr Lys Pro Arg Glu Glu Gln Tyr Ala Ser Thr Tyr Arg Val Val
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Ser Val Leu Thr Val Leu His Gln Asp Trp Leu Asn Gly Lys Glu Tyr
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Lys Cys Lys Val Ser Asn Lys Ala Leu Pro Ala Pro Ile Glu Lys Thr
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Ile Ser Lys Ala Lys Gly Gln Pro Arg Glu Pro Gln Val Tyr Thr Leu
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Pro Pro Ser Arg Glu Glu Met Thr Lys Asn Gln Val Ser Leu Thr Cys
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Leu Val Lys Gly Phe Tyr Pro Ser Asp Ile Ala Val Glu Trp Glu Ser
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Asn Gly Gln Pro Glu Asn Asn Tyr Lys Thr Thr Pro Pro Val Leu Asp
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Ser Asp Gly Ser Phe Phe Leu Tyr Ser Lys Leu Thr Val Asp Lys Ser
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Arg Trp Gln Gln Gly Asn Val Phe Ser Cys Ser Val Met His Glu Ala
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Leu His Asn His Tyr Thr Gln Lys Ser Leu Ser Leu Ser Pro Gly
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<210> 10
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<212> PRT
<213> Artificial sequence
<220>
<223> synthetic construct
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Asp Ile Gln Met Thr Gln Ser Pro Ser Ser Leu Ser Ala Ser Val Gly
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Asp Arg Val Thr Ile Thr Cys Arg Ala Ser Gln Asp Val Ser Thr Ala
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Val Ala Trp Tyr Gln Gln Lys Pro Gly Lys Ala Pro Lys Leu Leu Ile
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Tyr Ser Ala Ser Phe Leu Tyr Ser Gly Val Pro Ser Arg Phe Ser Gly
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Ser Gly Ser Gly Thr Asp Phe Thr Leu Thr Ile Ser Ser Leu Gln Pro
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Glu Asp Phe Ala Thr Tyr Tyr Cys Gln Gln Tyr Leu Tyr His Pro Ala
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Thr Phe Gly Gln Gly Thr Lys Val Glu Ile Lys Arg Thr Val Ala Ala
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Pro Ser Val Phe Ile Phe Pro Pro Ser Asp Glu Gln Leu Lys Ser Gly
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Thr Ala Ser Val Val Cys Leu Leu Asn Asn Phe Tyr Pro Arg Glu Ala
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Lys Val Gln Trp Lys Val Asp Asn Ala Leu Gln Ser Gly Asn Ser Gln
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Glu Ser Val Thr Glu Gln Asp Ser Lys Asp Ser Thr Tyr Ser Leu Ser
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Ser Thr Leu Thr Leu Ser Lys Ala Asp Tyr Glu Lys His Lys Val Tyr
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Ala Cys Glu Val Thr His Gln Gly Leu Ser Ser Pro Val Thr Lys Ser
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Phe Asn Arg Gly Glu Cys
210
<210> 11
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<212> PRT
<213> Artificial sequence
<220>
<223> synthetic construct
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Gln Val Gln Leu Val Glu Ser Gly Gly Gly Val Val Gln Pro Gly Arg
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Ser Leu Arg Leu Asp Cys Lys Ala Ser Gly Ile Thr Phe Ser Asn Ser
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Gly Met His Trp Val Arg Gln Ala Pro Gly Lys Gly Leu Glu Trp Val
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Ala Val Ile Trp Tyr Asp Gly Ser Lys Arg Tyr Tyr Ala Asp Ser Val
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Lys Gly Arg Phe Thr Ile Ser Arg Asp Asn Ser Lys Asn Thr Leu Phe
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Leu Gln Met Asn Ser Leu Arg Ala Glu Asp Thr Ala Val Tyr Tyr Cys
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Ala Thr Asn Asp Asp Tyr Trp Gly Gln Gly Thr Leu Val Thr Val Ser
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Ser Ala Ser Thr Lys Gly Pro Ser Val Phe Pro Leu Ala Pro Cys Ser
115 120 125
Arg Ser Thr Ser Glu Ser Thr Ala Ala Leu Gly Cys Leu Val Lys Asp
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Tyr Phe Pro Glu Pro Val Thr Val Ser Trp Asn Ser Gly Ala Leu Thr
145 150 155 160
Ser Gly Val His Thr Phe Pro Ala Val Leu Gln Ser Ser Gly Leu Tyr
165 170 175
Ser Leu Ser Ser Val Val Thr Val Pro Ser Ser Ser Leu Gly Thr Lys
180 185 190
Thr Tyr Thr Cys Asn Val Asp His Lys Pro Ser Asn Thr Lys Val Asp
195 200 205
Lys Arg Val Glu Ser Lys Tyr Gly Pro Pro Cys Pro Pro Cys Pro Ala
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Pro Glu Phe Leu Gly Gly Pro Ser Val Phe Leu Phe Pro Pro Lys Pro
225 230 235 240
Lys Asp Thr Leu Met Ile Ser Arg Thr Pro Glu Val Thr Cys Val Val
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Val Asp Val Ser Gln Glu Asp Pro Glu Val Gln Phe Asn Trp Tyr Val
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Asp Gly Val Glu Val His Asn Ala Lys Thr Lys Pro Arg Glu Glu Gln
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Phe Asn Ser Thr Tyr Arg Val Val Ser Val Leu Thr Val Leu His Gln
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Asp Trp Leu Asn Gly Lys Glu Tyr Lys Cys Lys Val Ser Asn Lys Gly
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Leu Pro Ser Ser Ile Glu Lys Thr Ile Ser Lys Ala Lys Gly Gln Pro
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Arg Glu Pro Gln Val Tyr Thr Leu Pro Pro Ser Gln Glu Glu Met Thr
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Lys Asn Gln Val Ser Leu Thr Cys Leu Val Lys Gly Phe Tyr Pro Ser
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Asp Ile Ala Val Glu Trp Glu Ser Asn Gly Gln Pro Glu Asn Asn Tyr
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Lys Thr Thr Pro Pro Val Leu Asp Ser Asp Gly Ser Phe Phe Leu Tyr
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Ser Arg Leu Thr Val Asp Lys Ser Arg Trp Gln Glu Gly Asn Val Phe
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Ser Cys Ser Val Met His Glu Ala Leu His Asn His Tyr Thr Gln Lys
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Ser Leu Ser Leu Ser Leu Gly Lys
435 440
<210> 12
<211> 214
<212> PRT
<213> Artificial sequence
<220>
<223> synthetic construct
<400> 12
Glu Ile Val Leu Thr Gln Ser Pro Ala Thr Leu Ser Leu Ser Pro Gly
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Glu Arg Ala Thr Leu Ser Cys Arg Ala Ser Gln Ser Val Ser Ser Tyr
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Leu Ala Trp Tyr Gln Gln Lys Pro Gly Gln Ala Pro Arg Leu Leu Ile
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Tyr Asp Ala Ser Asn Arg Ala Thr Gly Ile Pro Ala Arg Phe Ser Gly
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Ser Gly Ser Gly Thr Asp Phe Thr Leu Thr Ile Ser Ser Leu Glu Pro
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Glu Asp Phe Ala Val Tyr Tyr Cys Gln Gln Ser Ser Asn Trp Pro Arg
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Thr Phe Gly Gln Gly Thr Lys Val Glu Ile Lys Arg Thr Val Ala Ala
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Pro Ser Val Phe Ile Phe Pro Pro Ser Asp Glu Gln Leu Lys Ser Gly
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Thr Ala Ser Val Val Cys Leu Leu Asn Asn Phe Tyr Pro Arg Glu Ala
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Lys Val Gln Trp Lys Val Asp Asn Ala Leu Gln Ser Gly Asn Ser Gln
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Glu Ser Val Thr Glu Gln Asp Ser Lys Asp Ser Thr Tyr Ser Leu Ser
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Ser Thr Leu Thr Leu Ser Lys Ala Asp Tyr Glu Lys His Lys Val Tyr
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Ala Cys Glu Val Thr His Gln Gly Leu Ser Ser Pro Val Thr Lys Ser
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Phe Asn Arg Gly Glu Cys
210
<210> 13
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<212> DNA
<213> Intelligent people
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ccctgtggat gcacaaggtc ccagcatcat tgatggtgag cctgggggaa gacgcccact 180
tccaatgccc gcacaatagc agcaacaacg ccaacgtcac ctggtggcgc gtcctccatg 240
gcaactacac gtggccccct gagttcttgg gcccgggcga ggaccccaat ggtacgctga 300
tcatccagaa tgtgaacaag agccatgggg gcatatacgt gtgccgggtc caggagggca 360
acgagtcata ccagcagtcc tgcggcacct acctccgcgt gcgccagccg ccccccaggc 420
ccttcctgga catgggggag ggcaccaaga accgaatcat cacagccgag gggatcatcc 480
tcctgttctg cgcggtggtg cctgggacgc tgctgctgtt caggaaacga tggcagaacg 540
agaagctcgg gttggatgcc ggggatgaat atgaagatga aaacctttat gaaggcctga 600
acctggacga ctgctccatg tatgaggaca tctcccgggg cctccagggc acctaccagg 660
atgtgggcag cctcaacata ggagatgtcc agctggagaa gccgtgacac ccctactcct 720
gccaggctgc ccccgcctgc tgtgcaccca gctccagtgt ctcagctcac ttccctggga 780
cattctcctt tcagcccttc tgggggcttc cttagtcata ttcccccagt ggggggtggg 840
agggtaacct cactcttctc caggccaggc ctccttggac tcccctgggg gtgtcccact 900
cttcttccct ctaaactgcc ccacctccta acctaatccc cccgccccgc tgcctttccc 960
aggctcccct caccccagcg ggtaatgagc ccttaatcgc tgcctctagg ggagctgatt 1020
gtagcagcct cgttagtgtc accccctcct ccctgatctg tcagggccac ttagtgataa 1080
taaattcttc ccaactgca 1099
<210> 14
<211> 226
<212> PRT
<213> Intelligent people
<400> 14
Met Pro Gly Gly Pro Gly Val Leu Gln Ala Leu Pro Ala Thr Ile Phe
1 5 10 15
Leu Leu Phe Leu Leu Ser Ala Val Tyr Leu Gly Pro Gly Cys Gln Ala
20 25 30
Leu Trp Met His Lys Val Pro Ala Ser Leu Met Val Ser Leu Gly Glu
35 40 45
Asp Ala His Phe Gln Cys Pro His Asn Ser Ser Asn Asn Ala Asn Val
50 55 60
Thr Trp Trp Arg Val Leu His Gly Asn Tyr Thr Trp Pro Pro Glu Phe
65 70 75 80
Leu Gly Pro Gly Glu Asp Pro Asn Gly Thr Leu Ile Ile Gln Asn Val
85 90 95
Asn Lys Ser His Gly Gly Ile Tyr Val Cys Arg Val Gln Glu Gly Asn
100 105 110
Glu Ser Tyr Gln Gln Ser Cys Gly Thr Tyr Leu Arg Val Arg Gln Pro
115 120 125
Pro Pro Arg Pro Phe Leu Asp Met Gly Glu Gly Thr Lys Asn Arg Ile
130 135 140
Ile Thr Ala Glu Gly Ile Ile Leu Leu Phe Cys Ala Val Val Pro Gly
145 150 155 160
Thr Leu Leu Leu Phe Arg Lys Arg Trp Gln Asn Glu Lys Leu Gly Leu
165 170 175
Asp Ala Gly Asp Glu Tyr Glu Asp Glu Asn Leu Tyr Glu Gly Leu Asn
180 185 190
Leu Asp Asp Cys Ser Met Tyr Glu Asp Ile Ser Arg Gly Leu Gln Gly
195 200 205
Thr Tyr Gln Asp Val Gly Ser Leu Asn Ile Gly Asp Val Gln Leu Glu
210 215 220
Lys Pro
225
<210> 15
<211> 2707
<212> DNA
<213> Intelligent people
<400> 15
gtaataccta agagggaagt ggcttcattt cagtggctga cttccagaga gcaatatggc 60
tggttcccca acatgcctca ccctcatcta tatcctttgg cagctcacag ggtcagcagc 120
ctctggaccc gtgaaagagc tggtcggttc cgttggtggg gccgtgactt tccccctgaa 180
gtccaaagta aagcaagttg actctattgt ctggaccttc aacacaaccc ctcttgtcac 240
catacagcca gaagggggca ctatcatagt gacccaaaat cgtaataggg agagagtaga 300
cttcccagat ggaggctact ccctgaagct cagcaaactg aagaagaatg actcagggat 360
ctactatgtg gggatataca gctcatcact ccagcagccc tccacccagg agtacgtgct 420
gcatgtctac gagcacctgt caaagcctaa agtcaccatg ggtctgcaga gcaataagaa 480
tggcacctgt gtgaccaatc tgacatgctg catggaacat ggggaagagg atgtgattta 540
tacctggaag gccctggggc aagcagccaa tgagtcccat aatgggtcca tcctccccat 600
ctcctggaga tggggagaaa gtgatatgac cttcatctgc gttgccagga accctgtcag 660
cagaaacttc tcaagcccca tccttgccag gaagctctgt gaaggtgctg ctgatgaccc 720
agattcctcc atggtcctcc tgtgtctcct gttggtgccc ctcctgctca gtctctttgt 780
actggggcta tttctttggt ttctgaagag agagagacaa gaagagtaca ttgaagagaa 840
gaagagagtg gacatttgtc gggaaactcc taacatatgc ccccattctg gagagaacac 900
agagtacgac acaatccctc acactaatag aacaatccta aaggaagatc cagcaaatac 960
ggtttactcc actgtggaaa taccgaaaaa gatggaaaat ccccactcac tgctcacgat 1020
gccagacaca ccaaggctat ttgcctatga gaatgttatc tagacagcag tgcactcccc 1080
taagtctctg ctcaaaaaaa aaacaattct cggcccaaag aaaacaatca gaagaattca 1140
ctgatttgac tagaaacatc aaggaagaat gaagaacgtt gacttttttc caggataaat 1200
tatctctgat gcttctttag atttaagagt tcataattcc atccactgct gagaaatctc 1260
ctcaaaccca gaaggtttaa tcacttcatc ccaaaaatgg gattgtgaat gtcagcaaac 1320
cataaaaaaa gtgcttagaa gtattcctat aaaaatgtaa atgcaaggtc acacatatta 1380
atgacagcct gttgtattaa tgatggctcc aggtcagtgt ctggagtttc attccatccc 1440
agggcttgga tgtcaggatt ataccaagag tcttgctacc aggagggcaa gaagaccaaa 1500
acagacagac aagtccagca gaagcagatg cacctgacaa aaatggatgt attaattggc 1560
tctataaact atgtgcccag cactatgctg agcttacact aattggtcag acatgctgtc 1620
tgccctcatg aaattggctc caaatgaatg aactactttc atgagcagtt gtagcaggcc 1680
tgaccacaga ttcccagagg gccaggtgtg gatccacagg acttgaaggt caaagttcac 1740
aaagatgaag aatcagggta gctgaccatg tttggcagat actataatgg agacacagaa 1800
gtgtgcatgg cccaaggaca aggacctcca gccaggcttc atttatgcac ttgtgctgca 1860
aaagaaaagt ctaggtttta aggctgtgcc agaacccatc ccaataaaga gaccgagtct 1920
gaagtcacat tgtaaatcta gtgtaggaga cttggagtca ggcagtgaga ctggtggggc 1980
acggggggca gtgggtactt gtaaaccttt aaagatggtt aattcattca atagatattt 2040
attaagaacc tatgcggccc ggcatggtgg ctcacacctg taatcccagc actttgggag 2100
gccaaggtgg gtgggtcatc tgaggtcagg agttcaagac cagcctggcc aacatggtga 2160
aaccccatct ctactaaaga tacaaaaatt tgctgagcgt ggtggtgtgc acctgtaatc 2220
ccagctactc gagaggccaa ggcatgagaa tcgcttgaac ctgggaggtg gaggttgcag 2280
tgagctgaga tggcaccact gcactccggc ctaggcaacg agagcaaaac tccaatacaa 2340
acaaacaaac aaacacctgt gctaggtcag tctggcacgt aagatgaaca tccctaccaa 2400
tacagagctc accatctctt atacttaagt gaaaaacatg gggaagggga aaggggaatg 2460
gctgcttttg atatgttccc tgacacatat cttgaatgga gacctcccta ccaagtgatg 2520
aaagtgttga aaaacttaat aacaaatgct tgttgggcaa gaatgggatt gaggattatc 2580
ttctctcaga aaggcattgt gaaggaattg agccagatct ctctccctac tgcaaaaccc 2640
tattgtagta aaaaagtctt ctttactatc ttaataaaac agatattgtg agattcacat 2700
acaaaaa 2707
<210> 16
<211> 335
<212> PRT
<213> Intelligent people
<400> 16
Met Ala Gly Ser Pro Thr Cys Leu Thr Leu Ile Tyr Ile Leu Trp Gln
1 5 10 15
Leu Thr Gly Ser Ala Ala Ser Gly Pro Val Lys Glu Leu Val Gly Ser
20 25 30
Val Gly Gly Ala Val Thr Phe Pro Leu Lys Ser Lys Val Lys Gln Val
35 40 45
Asp Ser Ile Val Trp Thr Phe Asn Thr Thr Pro Leu Val Thr Ile Gln
50 55 60
Pro Glu Gly Gly Thr Ile Ile Val Thr Gln Asn Arg Asn Arg Glu Arg
65 70 75 80
Val Asp Phe Pro Asp Gly Gly Tyr Ser Leu Lys Leu Ser Lys Leu Lys
85 90 95
Lys Asn Asp Ser Gly Ile Tyr Tyr Val Gly Ile Tyr Ser Ser Ser Leu
100 105 110
Gln Gln Pro Ser Thr Gln Glu Tyr Val Leu His Val Tyr Glu His Leu
115 120 125
Ser Lys Pro Lys Val Thr Met Gly Leu Gln Ser Asn Lys Asn Gly Thr
130 135 140
Cys Val Thr Asn Leu Thr Cys Cys Met Glu His Gly Glu Glu Asp Val
145 150 155 160
Ile Tyr Thr Trp Lys Ala Leu Gly Gln Ala Ala Asn Glu Ser His Asn
165 170 175
Gly Ser Ile Leu Pro Ile Ser Trp Arg Trp Gly Glu Ser Asp Met Thr
180 185 190
Phe Ile Cys Val Ala Arg Asn Pro Val Ser Arg Asn Phe Ser Ser Pro
195 200 205
Ile Leu Ala Arg Lys Leu Cys Glu Gly Ala Ala Asp Asp Pro Asp Ser
210 215 220
Ser Met Val Leu Leu Cys Leu Leu Leu Val Pro Leu Leu Leu Ser Leu
225 230 235 240
Phe Val Leu Gly Leu Phe Leu Trp Phe Leu Lys Arg Glu Arg Gln Glu
245 250 255
Glu Tyr Ile Glu Glu Lys Lys Arg Val Asp Ile Cys Arg Glu Thr Pro
260 265 270
Asn Ile Cys Pro His Ser Gly Glu Asn Thr Glu Tyr Asp Thr Ile Pro
275 280 285
His Thr Asn Arg Thr Ile Leu Lys Glu Asp Pro Ala Asn Thr Val Tyr
290 295 300
Ser Thr Val Glu Ile Pro Lys Lys Met Glu Asn Pro His Ser Leu Leu
305 310 315 320
Thr Met Pro Asp Thr Pro Arg Leu Phe Ala Tyr Glu Asn Val Ile
325 330 335
<210> 17
<211> 2611
<212> DNA
<213> Intelligent
<400> 17
aactgagtgg ctgtgaaagg gtggggtttg ctcagactgt ccttcctctc tggactgtaa 60
gaatatgtct ccagggccag tgtctgctgc gatcgagtcc caccttccaa gtcctggcat 120
ctcaatgcat ctgggaagct acctgcatta agtcaggact gagcacacag gtgaactcca 180
gaaagaagaa gctatggccg cagtgattct ggagagcatc tttctgaagc gatcccaaca 240
gaaaaagaaa acatcacctc taaacttcaa gaagcgcctg tttctcttga ccgtgcacaa 300
actctcctac tatgagtatg actttgaacg tgggagaaga ggcagtaaga agggttcaat 360
agatgttgag aagatcactt gtgttgaaac agtggttcct gaaaaaaatc ctcctccaga 420
aagacagatt ccgagaagag gtgaagagtc cagtgaaatg gagcaaattt caatcattga 480
aaggttccct tatcccttcc aggttgtata tgatgaaggg cctctctacg tcttctcccc 540
aactgaagaa ctaaggaagc ggtggattca ccagctcaaa aacgtaatcc ggtacaacag 600
tgatctggtt cagaaatatc acccttgctt ctggatcgat gggcagtatc tctgctgctc 660
tcagacagcc aaaaatgcta tgggctgcca aattttggag aacaggaatg gaagcttaaa 720
acctgggagt tctcaccgga agacaaaaaa gcctcttccc ccaacgcctg aggaggacca 780
gatcttgaaa aagccactac cgcctgagcc agcagcagca ccagtctcca caagtgagct 840
gaaaaaggtt gtggcccttt atgattacat gccaatgaat gcaaatgatc tacagctgcg 900
gaagggtgat gaatatttta tcttggagga aagcaactta ccatggtgga gagcacgaga 960
taaaaatggg caggaaggct acattcctag taactatgtc actgaagcag aagactccat 1020
agaaatgtat gagtggtatt ccaaacacat gactcggagt caggctgagc aactgctaaa 1080
gcaagagggg aaagaaggag gtttcattgt cagagactcc agcaaagctg gcaaatatac 1140
agtgtctgtg tttgctaaat ccacagggga ccctcaaggg gtgatacgtc attatgttgt 1200
gtgttccaca cctcagagcc agtattacct ggctgagaag caccttttca gcaccatccc 1260
tgagctcatt aactaccatc agcacaactc tgcaggactc atatccaggc tcaaatatcc 1320
agtgtctcaa caaaacaaga atgcaccttc cactgcaggc ctgggatacg gatcatggga 1380
aattgatcca aaggacctga ccttcttgaa ggagctgggg actggacaat ttggggtagt 1440
gaagtatggg aaatggagag gccagtacga cgtggccatc aagatgatca aagaaggctc 1500
catgtctgaa gatgaattca ttgaagaagc caaagtcatg atgaatcttt cccatgagaa 1560
gctggtgcag ttgtatggcg tctgcaccaa gcagcgcccc atcttcatca tcactgagta 1620
catggccaat ggctgcctcc tgaactacct gagggagatg cgccaccgct tccagactca 1680
gcagctgcta gagatgtgca aggatgtctg tgaagccatg gaatacctgg agtcaaagca 1740
gttccttcac cgagacctgg cagctcgaaa ctgtttggta aacgatcaag gagttgttaa 1800
agtatctgat ttcggcctgt ccaggtatgt cctggatgat gaatacacaa gctcagtagg 1860
ctccaaattt ccagtccggt ggtccccacc ggaagtcctg atgtatagca agttcagcag 1920
caaatctgac atttgggctt ttggggtttt gatgtgggaa atttactccc tggggaagat 1980
gccatatgag agatttacta acagtgagac tgctgaacac attgcccaag gcctacgtct 2040
ctacaggcct catctggctt cagagaaggt atataccatc atgtacagtt gctggcatga 2100
gaaagcagat gagcgtccca ctttcaaaat tcttctgagc aatattctag atgtcatgga 2160
tgaagaatcc tgagctcgcc aataagcttc ttggttctac ttctcttctc cacaagcccc 2220
aatttcactt tctcagagga aatcccaagc ttaggagccc tggagccttt gtgctcccac 2280
tcaatacaaa aaggcccctc tctacatctg ggaatgcacc tcttctttga ttccctggga 2340
tagtggcttc tgagcaaagg ccaagaaatt attgtgcctg aaatttcccg agagaattaa 2400
gacagactga atttgcgatg aaaatatttt ttaggaggga ggatgtaaat agccgcacaa 2460
aggggtccaa cagctctttg agtaggcatt tggtagagct tgggggtgtg tgtgtggggg 2520
tggaccgaat ttggcaagaa tgaaatggtg tcataaagat gggaggggag ggtgttttga 2580
taaaataaaa ttactagaaa gcttgaaagt c 2611
<210> 18
<211> 659
<212> PRT
<213> Intelligent
<400> 18
Met Ala Ala Val Ile Leu Glu Ser Ile Phe Leu Lys Arg Ser Gln Gln
1 5 10 15
Lys Lys Lys Thr Ser Pro Leu Asn Phe Lys Lys Arg Leu Phe Leu Leu
20 25 30
Thr Val His Lys Leu Ser Tyr Tyr Glu Tyr Asp Phe Glu Arg Gly Arg
35 40 45
Arg Gly Ser Lys Lys Gly Ser Ile Asp Val Glu Lys Ile Thr Cys Val
50 55 60
Glu Thr Val Val Pro Glu Lys Asn Pro Pro Pro Glu Arg Gln Ile Pro
65 70 75 80
Arg Arg Gly Glu Glu Ser Ser Glu Met Glu Gln Ile Ser Ile Ile Glu
85 90 95
Arg Phe Pro Tyr Pro Phe Gln Val Val Tyr Asp Glu Gly Pro Leu Tyr
100 105 110
Val Phe Ser Pro Thr Glu Glu Leu Arg Lys Arg Trp Ile His Gln Leu
115 120 125
Lys Asn Val Ile Arg Tyr Asn Ser Asp Leu Val Gln Lys Tyr His Pro
130 135 140
Cys Phe Trp Ile Asp Gly Gln Tyr Leu Cys Cys Ser Gln Thr Ala Lys
145 150 155 160
Asn Ala Met Gly Cys Gln Ile Leu Glu Asn Arg Asn Gly Ser Leu Lys
165 170 175
Pro Gly Ser Ser His Arg Lys Thr Lys Lys Pro Leu Pro Pro Thr Pro
180 185 190
Glu Glu Asp Gln Ile Leu Lys Lys Pro Leu Pro Pro Glu Pro Ala Ala
195 200 205
Ala Pro Val Ser Thr Ser Glu Leu Lys Lys Val Val Ala Leu Tyr Asp
210 215 220
Tyr Met Pro Met Asn Ala Asn Asp Leu Gln Leu Arg Lys Gly Asp Glu
225 230 235 240
Tyr Phe Ile Leu Glu Glu Ser Asn Leu Pro Trp Trp Arg Ala Arg Asp
245 250 255
Lys Asn Gly Gln Glu Gly Tyr Ile Pro Ser Asn Tyr Val Thr Glu Ala
260 265 270
Glu Asp Ser Ile Glu Met Tyr Glu Trp Tyr Ser Lys His Met Thr Arg
275 280 285
Ser Gln Ala Glu Gln Leu Leu Lys Gln Glu Gly Lys Glu Gly Gly Phe
290 295 300
Ile Val Arg Asp Ser Ser Lys Ala Gly Lys Tyr Thr Val Ser Val Phe
305 310 315 320
Ala Lys Ser Thr Gly Asp Pro Gln Gly Val Ile Arg His Tyr Val Val
325 330 335
Cys Ser Thr Pro Gln Ser Gln Tyr Tyr Leu Ala Glu Lys His Leu Phe
340 345 350
Ser Thr Ile Pro Glu Leu Ile Asn Tyr His Gln His Asn Ser Ala Gly
355 360 365
Leu Ile Ser Arg Leu Lys Tyr Pro Val Ser Gln Gln Asn Lys Asn Ala
370 375 380
Pro Ser Thr Ala Gly Leu Gly Tyr Gly Ser Trp Glu Ile Asp Pro Lys
385 390 395 400
Asp Leu Thr Phe Leu Lys Glu Leu Gly Thr Gly Gln Phe Gly Val Val
405 410 415
Lys Tyr Gly Lys Trp Arg Gly Gln Tyr Asp Val Ala Ile Lys Met Ile
420 425 430
Lys Glu Gly Ser Met Ser Glu Asp Glu Phe Ile Glu Glu Ala Lys Val
435 440 445
Met Met Asn Leu Ser His Glu Lys Leu Val Gln Leu Tyr Gly Val Cys
450 455 460
Thr Lys Gln Arg Pro Ile Phe Ile Ile Thr Glu Tyr Met Ala Asn Gly
465 470 475 480
Cys Leu Leu Asn Tyr Leu Arg Glu Met Arg His Arg Phe Gln Thr Gln
485 490 495
Gln Leu Leu Glu Met Cys Lys Asp Val Cys Glu Ala Met Glu Tyr Leu
500 505 510
Glu Ser Lys Gln Phe Leu His Arg Asp Leu Ala Ala Arg Asn Cys Leu
515 520 525
Val Asn Asp Gln Gly Val Val Lys Val Ser Asp Phe Gly Leu Ser Arg
530 535 540
Tyr Val Leu Asp Asp Glu Tyr Thr Ser Ser Val Gly Ser Lys Phe Pro
545 550 555 560
Val Arg Trp Ser Pro Pro Glu Val Leu Met Tyr Ser Lys Phe Ser Ser
565 570 575
Lys Ser Asp Ile Trp Ala Phe Gly Val Leu Met Trp Glu Ile Tyr Ser
580 585 590
Leu Gly Lys Met Pro Tyr Glu Arg Phe Thr Asn Ser Glu Thr Ala Glu
595 600 605
His Ile Ala Gln Gly Leu Arg Leu Tyr Arg Pro His Leu Ala Ser Glu
610 615 620
Lys Val Tyr Thr Ile Met Tyr Ser Cys Trp His Glu Lys Ala Asp Glu
625 630 635 640
Arg Pro Thr Phe Lys Ile Leu Leu Ser Asn Ile Leu Asp Val Met Asp
645 650 655
Glu Glu Ser
<210> 19
<211> 891
<212> DNA
<213> Intelligent people
<400> 19
attgttctca acattctagc tgctcttgct gcatttgctc tggaattctt gtagagatat 60
tacttgtcct tccaggctgt tctttctgta gctcccttgt tttctttttg tgatcatgtt 120
gcagatggct gggcagtgct cccaaaatga atattttgac agtttgttgc atgcttgcat 180
accttgtcaa cttcgatgtt cttctaatac tcctcctcta acatgtcagc gttattgtaa 240
tgcaagtgtg accaattcag tgaaaggaac gaatgcgatt ctctggacct gtttgggact 300
gagcttaata atttctttgg cagttttcgt gctaatgttt ttgctaagga agataaactc 360
tgaaccatta aaggacgagt ttaaaaacac aggatcaggt ctcctgggca tggctaacat 420
tgacctggaa aagagcagga ctggtgatga aattattctt ccgagaggcc tcgagtacac 480
ggtggaagaa tgcacctgtg aagactgcat caagagcaaa ccgaaggtcg actctgacca 540
ttgctttcca ctcccagcta tggaggaagg cgcaaccatt cttgtcacca cgaaaacgaa 600
tgactattgc aagagcctgc cagctgcttt gagtgctacg gagatagaga aatcaatttc 660
tgctaggtaa ttaaccattt cgactcgagc agtgccactt taaaaatctt ttgtcagaat 720
agatgatgtg tcagatctct ttaggatgac tgtatttttc agttgccgat acagcttttt 780
gtcctctaac tgtggaaact ctttatgtta gatatatttc tctaggttac tgttgggagc 840
ttaatggtag aaacttcctt ggtttcatga ttaaactctt ttttttcctg a 891
<210> 20
<211> 184
<212> PRT
<213> Intelligent people
<400> 20
Met Leu Gln Met Ala Gly Gln Cys Ser Gln Asn Glu Tyr Phe Asp Ser
1 5 10 15
Leu Leu His Ala Cys Ile Pro Cys Gln Leu Arg Cys Ser Ser Asn Thr
20 25 30
Pro Pro Leu Thr Cys Gln Arg Tyr Cys Asn Ala Ser Val Thr Asn Ser
35 40 45
Val Lys Gly Thr Asn Ala Ile Leu Trp Thr Cys Leu Gly Leu Ser Leu
50 55 60
Ile Ile Ser Leu Ala Val Phe Val Leu Met Phe Leu Leu Arg Lys Ile
65 70 75 80
Asn Ser Glu Pro Leu Lys Asp Glu Phe Lys Asn Thr Gly Ser Gly Leu
85 90 95
Leu Gly Met Ala Asn Ile Asp Leu Glu Lys Ser Arg Thr Gly Asp Glu
100 105 110
Ile Ile Leu Pro Arg Gly Leu Glu Tyr Thr Val Glu Glu Cys Thr Cys
115 120 125
Glu Asp Cys Ile Lys Ser Lys Pro Lys Val Asp Ser Asp His Cys Phe
130 135 140
Pro Leu Pro Ala Met Glu Glu Gly Ala Thr Ile Leu Val Thr Thr Lys
145 150 155 160
Thr Asn Asp Tyr Cys Lys Ser Leu Pro Ala Ala Leu Ser Ala Thr Glu
165 170 175
Ile Glu Lys Ser Ile Ser Ala Arg
180
<210> 21
<211> 1286
<212> DNA
<213> Intelligent people
<400> 21
agaagaagtg aagtcaagat gaagaaccat ttgcttttct ggggagtcct ggcggttttt 60
attaaggctg ttcatgtgaa agcccaagaa gatgaaagga ttgttcttgt tgacaacaaa 120
tgtaagtgtg cccggattac ttccaggatc atccgttctt ccgaagatcc taatgaggac 180
attgtggaga gaaacatccg aattattgtt cctctgaaca acagggagaa tatctctgat 240
cccacctcac cattgagaac cagatttgtg taccatttgt ctgacctctg taaaaaatgt 300
gatcctacag aagtggagct ggataatcag atagttactg ctacccagag caatatctgt 360
gatgaagaca gtgctacaga gacctgctac acttatgaca gaaacaagtg ctacacagct 420
gtggtcccac tcgtatatgg tggtgagacc aaaatggtgg aaacagcctt aaccccagat 480
gcctgctatc ctgactaatt taagtcattg ctgactgcat agctcttttt cttgagaggc 540
tctccatttt gattcagaaa gttagcatat ttattaccaa tgaatttgaa accagggctt 600
tttttttttt ttgggtgatg taaaaccaac tccctgccac caaaataatt aaaatagtca 660
cattgttatc tttattaggt aatcacttct taattatatg ttcatactct aagtatcaaa 720
atcttccaat tatcatgctc acctgaaaga ggtatgctct cttaggaata cagtttctag 780
cattaaacaa ataaacaagg ggagaaaata aaactcaagg actgaaaatc aggaggtgta 840
ataaaatgtt cctcgcattc ccccccgctt tttttttttt ttttgacttt gccttggaga 900
gccagagctt ccgcattttc tttactattc tttttaaaaa aagtttcact gtgtagagaa 960
catatatgca taaacatagg tcaattatat gtctccatta gaaaaataat aattggaaaa 1020
catgttctag aactagttac aaaaataatt taaggtgaaa tctctaatat ttataaaagt 1080
agcaaaataa atgcataatt aaaatatatt tggacataac agacttggaa gcagatgata 1140
cagacttctt tttttcataa tcaggttagt gtaagaaatt gccatttgaa acaatccatt 1200
ttgtaactga accttatgaa atatatgtat ttcatggtac gtattctcta gcacagtctg 1260
agcaattaaa tagattcata agcata 1286
<210> 22
<211> 159
<212> PRT
<213> Intelligent
<400> 22
Met Lys Asn His Leu Leu Phe Trp Gly Val Leu Ala Val Phe Ile Lys
1 5 10 15
Ala Val His Val Lys Ala Gln Glu Asp Glu Arg Ile Val Leu Val Asp
20 25 30
Asn Lys Cys Lys Cys Ala Arg Ile Thr Ser Arg Ile Ile Arg Ser Ser
35 40 45
Glu Asp Pro Asn Glu Asp Ile Val Glu Arg Asn Ile Arg Ile Ile Val
50 55 60
Pro Leu Asn Asn Arg Glu Asn Ile Ser Asp Pro Thr Ser Pro Leu Arg
65 70 75 80
Thr Arg Phe Val Tyr His Leu Ser Asp Leu Cys Lys Lys Cys Asp Pro
85 90 95
Thr Glu Val Glu Leu Asp Asn Gln Ile Val Thr Ala Thr Gln Ser Asn
100 105 110
Ile Cys Asp Glu Asp Ser Ala Thr Glu Thr Cys Tyr Thr Tyr Asp Arg
115 120 125
Asn Lys Cys Tyr Thr Ala Val Val Pro Leu Val Tyr Gly Gly Glu Thr
130 135 140
Lys Met Val Glu Thr Ala Leu Thr Pro Asp Ala Cys Tyr Pro Asp
145 150 155
<210> 23
<211> 1300
<212> DNA
<213> Intelligent
<400> 23
gtgaccgctt cagggcagtt ggtagatgcc cctctgggag agatccccag gggtgacagc 60
catggaccct ggaagggcct gggctaggga cagggaccag agccagtcca gggagaggac 120
agagccaatg gactggggtg tactgtaaca gccctgctgg cgagagggac cagggcaccg 180
tcctccaggg agcccatgct gcaagtcggg ccagaggtgc ccctgaacct gaaggccaat 240
gagacccaag acaggccaag tgggttgtga gacccctgag gagctgggcc ctggtcccag 300
gcagcgctgg cccctgctgc tgctgggtct ggccatggtc gcccatggcc tgctgcgccc 360
aatggttgca ccgcaaagcg gggacccaga ccctggagcc tcagttggaa gcagccgatc 420
cagcctgcgg agcctgtggg gcaggctcct gctccagccc agcccccaga gagcagaccc 480
caggtgctgg ccccgggggt tttggtctga gcctcagtca ctgtgttatg tcttcggaac 540
tgggaccaag gtcaccgtcc taggtcagcc caaggccaac cccactgtca ctctgttccc 600
gccctcctct gaggagctcc aagccaacaa ggccacacta gtgtgtctga tcagtgactt 660
ctacccggga gctgtgacag tggcctggaa ggcagatggc agccccgtca aggcgggagt 720
ggagaccacc aaaccctcca aacagagcaa caacaagtac gcggccagca gctacctgag 780
cctgacgccc gagcagtgga agtcccacag aagctacagc tgccaggtca cgcatgaagg 840
gagcaccgtg gagaagacag tggcccctac agaatgttca taggttccca actctaaccc 900
cacccacggg agcctggagc tgcaggatcc caggggaggg gtctctctcc ccatcccaag 960
tcatccagcc cttctccctg cactcatgaa accccaataa atatcctcat tgacaaccag 1020
aaatcttgtt ttatctcatt ttttttctca cataaattgc tagcctcccc ggggttctca 1080
gtgtggggta cagggaattc tgcacccagt gtgaaaatca cccaagggag gaggctcaca 1140
gcctccctga gtcatctccc cagagggtcc ttcctctccc agtcacccct tctccaactc 1200
tccactgtac ccctgagcta ccagtctggc atcagttcag accagtccca caccctccta 1260
aattttactt ctcaataaat acctgatcat gtaaaacgca 1300
<210> 24
<211> 214
<212> PRT
<213> Intelligent people
<400> 24
Met Arg Pro Lys Thr Gly Gln Val Gly Cys Glu Thr Pro Glu Glu Leu
1 5 10 15
Gly Pro Gly Pro Arg Gln Arg Trp Pro Leu Leu Leu Leu Gly Leu Ala
20 25 30
Met Val Ala His Gly Leu Leu Arg Pro Met Val Ala Pro Gln Ser Gly
35 40 45
Asp Pro Asp Pro Gly Ala Ser Val Gly Ser Ser Arg Ser Ser Leu Arg
50 55 60
Ser Leu Trp Gly Arg Leu Leu Leu Gln Pro Ser Pro Gln Arg Ala Asp
65 70 75 80
Pro Arg Cys Trp Pro Arg Gly Phe Trp Ser Glu Pro Gln Ser Leu Cys
85 90 95
Tyr Val Phe Gly Thr Gly Thr Lys Val Thr Val Leu Gly Gln Pro Lys
100 105 110
Ala Asn Pro Thr Val Thr Leu Phe Pro Pro Ser Ser Glu Glu Leu Gln
115 120 125
Ala Asn Lys Ala Thr Leu Val Cys Leu Ile Ser Asp Phe Tyr Pro Gly
130 135 140
Ala Val Thr Val Ala Trp Lys Ala Asp Gly Ser Pro Val Lys Ala Gly
145 150 155 160
Val Glu Thr Thr Lys Pro Ser Lys Gln Ser Asn Asn Lys Tyr Ala Ala
165 170 175
Ser Ser Tyr Leu Ser Leu Thr Pro Glu Gln Trp Lys Ser His Arg Ser
180 185 190
Tyr Ser Cys Gln Val Thr His Glu Gly Ser Thr Val Glu Lys Thr Val
195 200 205
Ala Pro Thr Glu Cys Ser
210
<210> 25
<211> 5878
<212> DNA
<213> Intelligent people
<400> 25
attgggtaca tgcgcagtgc cgctcgcgcg ggccgcgcca atcctgcagc gccttcaaca 60
ggtttcgggc ggcgaattcc agttctccgg gttttggggc tccctgcggg aggcagtgct 120
ggatctggga atctctagga aaggaaagag caaaggaggg gaaagatggg gggctgcagt 180
ctccacgtac gtccctcaaa gcgcgtccta aaacccggat aaccggagcg ctccccatgg 240
accacacgga gggctcgccc gcggaggagc cgcctgcgca tgctccatcg cctgggaaat 300
ttggtgagcg gcctccacct aaacgactta ctagggaagc tatgcgaaat tatttaaaag 360
agcgagggga tcaaacagta cttattcttc atgcaaaagt tgcacagaag tcatatggaa 420
atgaaaaaag gtttttttgc ccacctcctt gtgtatatct tatgggcagt ggatggaaga 480
aaaaaaaaga acaaatggaa cgcgatggtt gttctgaaca agagtctcaa ccgtgtgcat 540
ttattgggat aggaaatagt gaccaagaaa tgcagcagct aaacttggaa ggaaagaact 600
attgcacagc caaaacattg tatatatctg actcagacaa gcgaaagcac ttcatgttgt 660
ctgtaaagat gttctatggc aacagtgatg acattggtgt gttcctcagc aagcggataa 720
aagtcatctc caaaccttcc aaaaagaagc agtcattgaa aaatgctgac ttatgcattg 780
cctcaggaac aaaggtggct ctgtttaatc gactacgatc ccagacagtt agtaccagat 840
acttgcatgt agaaggaggt aattttcatg ccagttcaca gcagtgggga gcctttttta 900
ttcatctctt ggatgatgat gaatcagaag gagaagaatt cacagtccga gatggctaca 960
tccattatgg acaaacagtc aaacttgtgt gctcagttac tggcatggca ctcccaagat 1020
tgataattag gaaagttgat aagcagaccg cattattgga tgcagatgat cctgtgtcac 1080
aactccataa atgtgcattt taccttaagg atacagaaag aatgtatttg tgcctttctc 1140
aagaaagaat aattcaattt caggccactc catgtccaaa agaaccaaat aaagagatga 1200
taaatgatgg cgcttcctgg acaatcatta gcacagataa ggcagagtat acattttatg 1260
agggaatggg ccctgtcctt gccccagtca ctcctgtgcc tgtggtagag agccttcagt 1320
tgaatggcgg tggggacgta gcaatgcttg aacttacagg acagaatttc actccaaatt 1380
tacgagtgtg gtttggggat gtagaagctg aaactatgta caggtgtgga gagagtatgc 1440
tctgtgtcgt cccagacatt tctgcattcc gagaaggttg gagatgggtc cggcaaccag 1500
tccaggttcc agtaactttg gtccgaaatg atggaatcat ttattccacc agccttacct 1560
ttacctacac accagaacca gggccgcggc cacattgcag tgcagcagga gcaatccttc 1620
gagccaattc aagccaggtg ccccctaacg aatcaaacac aaacagcgag ggaagttaca 1680
caaacgccag cacaaattca accagtgtca catcatctac agccacagtg gtatcctaac 1740
taccgtcttt ttgctaggac ttaaactgac ttgagtgtgg caaaaagtta acaaaaaagg 1800
agaaaaaatg aacaatcgtt tgtggtttct tgggaaaact tttcatacca ggtgatacta 1860
ttcaaaaacc ccgttgtctc cctgcaagtg ctgatttgaa atgcagaagc cacagtaaaa 1920
aaaaaaaaaa aaaaaaaaaa aaagaaaaaa aaatcaaaat gtataaatat tggaaatcaa 1980
gtttttcagc tgttttgttg gttggttggt tggtttttgt ttggttttgt ttaaatgggc 2040
aagaagtaaa taatgtggct ggaatacaag ttgaacaaac tagaagacac aaatctaaca 2100
tagtttttat ggaccaagga acttgtatat tgtataagct ttagtaaaag gtacattttc 2160
accatacctt tttttatatc acggtattat agtacacctt gttaccaaat aggttgttct 2220
cttccccacc cacctttgag cttttgctct aaaatacatt caggttccaa gcctgaccat 2280
ccttgtttaa tctatcatac tcttccaggt tttttttttt tggtctaagg ctggaacttt 2340
tttctttttt ttcagctgaa gtcttatgac ttttcatgag tcaaaattgt ttggatttca 2400
gcaagtcaaa tcttgcaaag gcctgcatat tttttttaag attatatgaa gtctgtgcaa 2460
aagctttaaa aaaatgcctc tgccttgcct gcaatacatg caatgtatgt taacttagtc 2520
tctcttctca gacactgttg gtagttattt ctgtgttttc ctttttttaa aaaaaaatat 2580
ggacttattg tggttatctg agaggttcta acattcacat gcaatttggt gtggccattt 2640
agctattaat gagttaatgg cgcagaactt gttgatattt gaagtgttct ctcccctttt 2700
cccatgacgt aaatacatag gtgtgttcca ggatttgttc aggtttttcc cccctcctaa 2760
tcttgtacat aacttgtatt atgtgtaagt taaacatttt attttgaact tggaatgttc 2820
ccagtgattt cattcagcag ggtattttct gccttgttgg caagtgacaa aaaatatggg 2880
aagtatttgc taccagttgg tagatggtgc ccttaatggt agaatgagga aaatgtccgc 2940
aaaagcatgt tttattatct ttactttttt ggggggttgg agggggtagc ctagccagaa 3000
catcattgta atcttaaaac ataagatgct tttattagat gatcaactaa aatagctgga 3060
agacagtact ttagaaacag atagttgtaa gattataaaa tgcaaatgta acttatgttt 3120
tcattttttt ctctgccttt tttgtttgtt tgttttctct tttccagtac tgagcatctc 3180
cacaaatgtc tcctaactca gaaaatgttt cttttctttt cagttgagat ttggttgcat 3240
tcagggttgt aggttggcct tgcttgctaa ccccgccggt tttaccgtgc tttcattcct 3300
gaactttgtt tatgcctttg tttggtttct tcgaaattgc agcagactca ttgggctaca 3360
tttagtacag gaaccacgtg tgtaatgtta tacaacacag tctagtaata caatcatccc 3420
tcttagagta aaaactacct ctagattgtg gtaagctttt actgtcccat aaaacaggag 3480
ccacagtacc ttatgaatgc aaaactgtaa cttcctacag tgtttcccta cagaacattg 3540
tctttctggt gtcctgggct gttttgaaaa agtttccatt aatagacttt ttagaaatta 3600
ttattagtag catttttttt ccagctttgc tgtcttcatc actcactcta tgctcagact 3660
atgccactgt aaatattctt cctaacatct ttaaatcgcc ttttcctcag ttttcaaggg 3720
gaaggtcatt tgtaaagcac gttaggtggt taaatcagtt attgcggttt tctcttactg 3780
caagcctttt taatcacccc caggctgcat tttattctat atcgcctttt ttcttcaaat 3840
ctgctccaat cactcacttc tctcttataa gctaatcctg cctcacacct taaatctgtt 3900
tcagtgatca agggcagaac tcattgtggc cttatctttc tttgttgtaa ttgttcactg 3960
tctctttctt acagaccact tatttctgag tagtagttat tcctctctat ggagtcatgg 4020
caggaatcat tacacagtgc ttttgttcag agcatggaca tgttcctagt gctgctttgc 4080
tttaacggcc acaagtttcc tccacttcct aggtttggta tttagttaag gaatcatatt 4140
aaattaacca ataacaaaag agatactttt gaagaacaaa ctattcctta cccatttttg 4200
tagctcaaaa ataatttttc aagttcatga ccttattaaa atgaacttgt gtttttttaa 4260
caaacatgta tgttttattt tgatagtttc tttccgtaag ataattgaaa tattatactg 4320
taaacccttt tcttttcttt ttttgaaaag tccaagaatg tacttataca ggcatttttc 4380
cccacctatt tttggccatt ctcataccac agactaaaga gtgaaatgat ttgtccattg 4440
tagcttattg tttatcagta gttcttttgt cagctgctta cattttttct ttcatggttt 4500
tgtgaatcat tttcagtatg taatttatag gaaccttgtc ctctggttat agtagactgt 4560
gtgccctcct ccagtgatgg cattattaga catgctggtc atttaccctc agaaagactc 4620
tcttattaga atggtgagtg cttcagttat agtatgtttg aatttttaaa aaattctgtt 4680
ttagaaatgt atcttatgct ctcatgacta tgcagtttct aaacatacac atagaagctg 4740
agtctctgat ccaatatgtt tttatttgtt ccatttaatt tatcacatag attgggaagg 4800
caagctaaaa gccttaaaaa tgccctttat attttgagtg atttcagcgt tgaacactag 4860
tatactatct aaatttgctg ctcactttct ttaaactgtg gcaattaaag gcatgtttat 4920
acatgactta atcgtgaaat gtttgtcact cttactgcac agacttatct gcaatcataa 4980
ctggttagtt tttttgtttt gttttgtttt attgttttta atgaaactgg taccatctgt 5040
gctttcacaa aaaacttcca atgccatttt tgagaactaa cctaactagt catgctaacc 5100
agaaaatcca ctggggagga ggttcctttt gaaacaaaat gctgttcagt tagtaaccaa 5160
gttactttga ttgcaaaagc agctgtgttt ctgataagta ctgaacaaat gtgtgtaatt 5220
ttctgtgcca gacttatgac tttgttttca agcactgtaa tgtgggatgg atggttagaa 5280
acaataatat attagggttt ctgtttaacc ctttcaggac tgaactgtat ctccttttgt 5340
taattttccc ctgtgttgtg ataaatgttt gccagcattc agtactgtgt tggtccagat 5400
gtaggtttat atgctcattt ttagcttatt tcttgtacct tgcagcatgc tctacgcatt 5460
cagtccttaa ggggtttatt ttacaaactg tgcgcctgta aggtttatta gcaataagat 5520
agaaaattga gcaagtttat accataattt tgtagaaaaa aagaatctgc tcagttccat 5580
atttcatccg tgaaaaactt gcaatacgag cagtttcaag gaataaataa aaaggaaatg 5640
taaaccattg taaaagtctt ctgtcgaatg tgcctgatgc atgtattatc gtcttttatt 5700
tcagaatact tcataaagat aaaattaaat tctatattat agttggtgta tttacaatct 5760
taccatgtac atcacatcaa agtgatagct ctactaattt aatttccttg tcaatgtttt 5820
taactatata gtgctttaaa gagatttttt ttccctgtgt aaaaaaaaaa aaaaaaaa 5878
<210> 26
<211> 500
<212> PRT
<213> Intelligent people
<400> 26
Met Asp His Thr Glu Gly Ser Pro Ala Glu Glu Pro Pro Ala His Ala
1 5 10 15
Pro Ser Pro Gly Lys Phe Gly Glu Arg Pro Pro Pro Lys Arg Leu Thr
20 25 30
Arg Glu Ala Met Arg Asn Tyr Leu Lys Glu Arg Gly Asp Gln Thr Val
35 40 45
Leu Ile Leu His Ala Lys Val Ala Gln Lys Ser Tyr Gly Asn Glu Lys
50 55 60
Arg Phe Phe Cys Pro Pro Pro Cys Val Tyr Leu Met Gly Ser Gly Trp
65 70 75 80
Lys Lys Lys Lys Glu Gln Met Glu Arg Asp Gly Cys Ser Glu Gln Glu
85 90 95
Ser Gln Pro Cys Ala Phe Ile Gly Ile Gly Asn Ser Asp Gln Glu Met
100 105 110
Gln Gln Leu Asn Leu Glu Gly Lys Asn Tyr Cys Thr Ala Lys Thr Leu
115 120 125
Tyr Ile Ser Asp Ser Asp Lys Arg Lys His Phe Met Leu Ser Val Lys
130 135 140
Met Phe Tyr Gly Asn Ser Asp Asp Ile Gly Val Phe Leu Ser Lys Arg
145 150 155 160
Ile Lys Val Ile Ser Lys Pro Ser Lys Lys Lys Gln Ser Leu Lys Asn
165 170 175
Ala Asp Leu Cys Ile Ala Ser Gly Thr Lys Val Ala Leu Phe Asn Arg
180 185 190
Leu Arg Ser Gln Thr Val Ser Thr Arg Tyr Leu His Val Glu Gly Gly
195 200 205
Asn Phe His Ala Ser Ser Gln Gln Trp Gly Ala Phe Phe Ile His Leu
210 215 220
Leu Asp Asp Asp Glu Ser Glu Gly Glu Glu Phe Thr Val Arg Asp Gly
225 230 235 240
Tyr Ile His Tyr Gly Gln Thr Val Lys Leu Val Cys Ser Val Thr Gly
245 250 255
Met Ala Leu Pro Arg Leu Ile Ile Arg Lys Val Asp Lys Gln Thr Ala
260 265 270
Leu Leu Asp Ala Asp Asp Pro Val Ser Gln Leu His Lys Cys Ala Phe
275 280 285
Tyr Leu Lys Asp Thr Glu Arg Met Tyr Leu Cys Leu Ser Gln Glu Arg
290 295 300
Ile Ile Gln Phe Gln Ala Thr Pro Cys Pro Lys Glu Pro Asn Lys Glu
305 310 315 320
Met Ile Asn Asp Gly Ala Ser Trp Thr Ile Ile Ser Thr Asp Lys Ala
325 330 335
Glu Tyr Thr Phe Tyr Glu Gly Met Gly Pro Val Leu Ala Pro Val Thr
340 345 350
Pro Val Pro Val Val Glu Ser Leu Gln Leu Asn Gly Gly Gly Asp Val
355 360 365
Ala Met Leu Glu Leu Thr Gly Gln Asn Phe Thr Pro Asn Leu Arg Val
370 375 380
Trp Phe Gly Asp Val Glu Ala Glu Thr Met Tyr Arg Cys Gly Glu Ser
385 390 395 400
Met Leu Cys Val Val Pro Asp Ile Ser Ala Phe Arg Glu Gly Trp Arg
405 410 415
Trp Val Arg Gln Pro Val Gln Val Pro Val Thr Leu Val Arg Asn Asp
420 425 430
Gly Ile Ile Tyr Ser Thr Ser Leu Thr Phe Thr Tyr Thr Pro Glu Pro
435 440 445
Gly Pro Arg Pro His Cys Ser Ala Ala Gly Ala Ile Leu Arg Ala Asn
450 455 460
Ser Ser Gln Val Pro Pro Asn Glu Ser Asn Thr Asn Ser Glu Gly Ser
465 470 475 480
Tyr Thr Asn Ala Ser Thr Asn Ser Thr Ser Val Thr Ser Ser Thr Ala
485 490 495
Thr Val Val Ser
500
<210> 27
<211> 925
<212> DNA
<213> Intelligent people
<400> 27
acacacacat ctgcacctca accacagact acacttgctg aactggctcc tggggccatg 60
aggctgtcac tgccactgct gctgctgctg ctgggagcct gggccatccc agggggcctc 120
ggggacaggg cgccactcac agccacagcc ccacaactgg atgatgagga gatgtactca 180
gcccacatgc ccgctcacct gcgctgtgat gcctgcagag ctgtggctta ccagatgtgg 240
caaaatctgg caaaggcaga gaccaaactt catacctcaa actctggggg gcggcgggag 300
ctgagcgagt tggtctacac ggatgtcctg gaccggagct gctcccggaa ctggcaggac 360
tacggagttc gagaagtgga ccaagtgaaa cgtctcacag gcccaggact tagcgagggg 420
ccagagccaa gcatcagcgt gatggtcaca gggggcccct ggcctaccag gctctccagg 480
acatgtttgc actacttggg ggagtttgga gaagaccaga tctatgaagc ccaccaacaa 540
ggccgagggg ctctggaggc attgctatgt gggggacccc agggggcctg ctcagagaag 600
gtgtcagcca caagagaaga gctctagtcc tggactctac cctcctctga aagaagctgg 660
ggcttgctct gacggtctcc actcccgtct gcaggcagcc aggagggcag gaagcccttg 720
ctctgtgctg ccatcctgcc tccctcctcc agcctcaggg cactcgggcc tgggtgggag 780
tcaacgcctt cccctctgga ctcaaataaa acccagtgac ctcacttctt ttctctgcaa 840
aaggtgcttg tggggctggg agtgcagaca ttggtgtttc tgctgatgtc ccttgtgaaa 900
aaaaaaaaaa aactctcaaa atcaa 925
<210> 28
<211> 189
<212> PRT
<213> Intelligent people
<400> 28
Met Arg Leu Ser Leu Pro Leu Leu Leu Leu Leu Leu Gly Ala Trp Ala
1 5 10 15
Ile Pro Gly Gly Leu Gly Asp Arg Ala Pro Leu Thr Ala Thr Ala Pro
20 25 30
Gln Leu Asp Asp Glu Glu Met Tyr Ser Ala His Met Pro Ala His Leu
35 40 45
Arg Cys Asp Ala Cys Arg Ala Val Ala Tyr Gln Met Trp Gln Asn Leu
50 55 60
Ala Lys Ala Glu Thr Lys Leu His Thr Ser Asn Ser Gly Gly Arg Arg
65 70 75 80
Glu Leu Ser Glu Leu Val Tyr Thr Asp Val Leu Asp Arg Ser Cys Ser
85 90 95
Arg Asn Trp Gln Asp Tyr Gly Val Arg Glu Val Asp Gln Val Lys Arg
100 105 110
Leu Thr Gly Pro Gly Leu Ser Glu Gly Pro Glu Pro Ser Ile Ser Val
115 120 125
Met Val Thr Gly Gly Pro Trp Pro Thr Arg Leu Ser Arg Thr Cys Leu
130 135 140
His Tyr Leu Gly Glu Phe Gly Glu Asp Gln Ile Tyr Glu Ala His Gln
145 150 155 160
Gln Gly Arg Gly Ala Leu Glu Ala Leu Leu Cys Gly Gly Pro Gln Gly
165 170 175
Ala Cys Ser Glu Lys Val Ser Ala Thr Arg Glu Glu Leu
180 185
<210> 29
<211> 741
<212> DNA
<213> Intelligent people
<400> 29
gagaggctga gactaaccca gaaacatcca attctcaaac tgaagctcgc actctcgcct 60
ccagcatgaa agtctctgcc gcccttctgt gcctgctgct catagcagcc accttcattc 120
cccaagggct cgctcagcca gatgcaatca atgccccagt cacctgctgt tataacttca 180
ccaataggaa gatctcagtg cagaggctcg cgagctatag aagaatcacc agcagcaagt 240
gtcccaaaga agctgtgatc ttcaagacca ttgtggccaa ggagatctgt gctgacccca 300
agcagaagtg ggttcaggat tccatggacc acctggacaa gcaaacccaa actccgaaga 360
cttgaacact cactccacaa cccaagaatc tgcagctaac ttattttccc ctagctttcc 420
ccagacaccc tgttttattt tattataatg aattttgttt gttgatgtga aacattatgc 480
cttaagtaat gttaattctt atttaagtta ttgatgtttt aagtttatct ttcatggtac 540
tagtgttttt tagatacaga gacttgggga aattgctttt cctcttgaac cacagttcta 600
cccctgggat gttttgaggg tctttgcaag aatcattaat acaaagaatt ttttttaaca 660
ttccaatgca ttgctaaaat attattgtgg aaatgaatat tttgtaacta ttacaccaaa 720
taaatatatt tttgtacaaa a 741
<210> 30
<211> 99
<212> PRT
<213> Intelligent people
<400> 30
Met Lys Val Ser Ala Ala Leu Leu Cys Leu Leu Leu Ile Ala Ala Thr
1 5 10 15
Phe Ile Pro Gln Gly Leu Ala Gln Pro Asp Ala Ile Asn Ala Pro Val
20 25 30
Thr Cys Cys Tyr Asn Phe Thr Asn Arg Lys Ile Ser Val Gln Arg Leu
35 40 45
Ala Ser Tyr Arg Arg Ile Thr Ser Ser Lys Cys Pro Lys Glu Ala Val
50 55 60
Ile Phe Lys Thr Ile Val Ala Lys Glu Ile Cys Ala Asp Pro Lys Gln
65 70 75 80
Lys Trp Val Gln Asp Ser Met Asp His Leu Asp Lys Gln Thr Gln Thr
85 90 95
Pro Lys Thr
<210> 31
<211> 780
<212> DNA
<213> Intelligent people
<400> 31
agaaggacac gggcagcaga cagtggtcag tcctttcttg gctctgctga cactcgagcc 60
cacattccgt cacctgctca gaatcatgca ggtctccact gctgcccttg ctgtcctcct 120
ctgcaccatg gctctctgca accagttctc tgcatcactt gctgctgaca cgccgaccgc 180
ctgctgcttc agctacacct cccggcagat tccacagaat ttcatagctg actactttga 240
gacgagcagc cagtgctcca agcccggtgt catcttccta accaagcgaa gccggcaggt 300
ctgtgctgac cccagtgagg agtgggtcca gaaatatgtc agcgacctgg agctgagtgc 360
ctgaggggtc cagaagcttc gaggcccagc gacctcggtg ggcccagtgg ggaggagcag 420
gagcctgagc cttgggaaca tgcgtgtgac ctccacagct acctcttcta tggactggtt 480
gttgccaaac agccacactg tgggactctt cttaacttaa attttaattt atttatacta 540
tttagttttt gtaatttatt ttcgatttca cagtgtgttt gtgattgttt gctctgagag 600
ttcccctgtc ccctccccct tccctcacac cgcgtctggt gacaaccgag tggctgtcat 660
cagcctgtgt aggcagtcat ggcaccaaag ccaccagact gacaaatgtg tatcggatgc 720
ttttgttcag ggctgtgatc ggcctgggga aataataaag atgctctttt aaaaggtaaa 780
<210> 32
<211> 92
<212> PRT
<213> Intelligent people
<400> 32
Met Gln Val Ser Thr Ala Ala Leu Ala Val Leu Leu Cys Thr Met Ala
1 5 10 15
Leu Cys Asn Gln Phe Ser Ala Ser Leu Ala Ala Asp Thr Pro Thr Ala
20 25 30
Cys Cys Phe Ser Tyr Thr Ser Arg Gln Ile Pro Gln Asn Phe Ile Ala
35 40 45
Asp Tyr Phe Glu Thr Ser Ser Gln Cys Ser Lys Pro Gly Val Ile Phe
50 55 60
Leu Thr Lys Arg Ser Arg Gln Val Cys Ala Asp Pro Ser Glu Glu Trp
65 70 75 80
Val Gln Lys Tyr Val Ser Asp Leu Glu Leu Ser Ala
85 90
<210> 33
<211> 660
<212> DNA
<213> Intelligent people
<400> 33
agcacaggac acagctgggt tctgaagctt ctgagttctg cagcctcacc tctgagaaaa 60
cctcttttcc accaatacca tgaagctctg cgtgactgtc ctgtctctcc tcatgctagt 120
agctgccttc tgctctccag cgctctcagc accaatgggc tcagaccctc ccaccgcctg 180
ctgcttttct tacaccgcga ggaagcttcc tcgcaacttt gtggtagatt actatgagac 240
cagcagcctc tgctcccagc cagctgtggt attccaaacc aaaagaagca agcaagtctg 300
tgctgatccc agtgaatcct gggtccagga gtacgtgtat gacctggaac tgaactgagc 360
tgctcagaga caggaagtct tcagggaagg tcacctgagc ccggatgctt ctccatgaga 420
cacatctcct ccatactcag gactcctctc cgcagttcct gtcccttctc ttaatttaat 480
cttttttatg tgccgtgtta ttgtattagg tgtcatttcc attatttata ttagtttagc 540
caaaggataa gtgtccccta tggggatggt ccactgtcac tgtttctctg ctgttgcaaa 600
tacatggata acacatttga ttctgtgtgt tttcataata aaactttaaa ataaaatgca 660
<210> 34
<211> 92
<212> PRT
<213> Intelligent people
<400> 34
Met Lys Leu Cys Val Thr Val Leu Ser Leu Leu Met Leu Val Ala Ala
1 5 10 15
Phe Cys Ser Pro Ala Leu Ser Ala Pro Met Gly Ser Asp Pro Pro Thr
20 25 30
Ala Cys Cys Phe Ser Tyr Thr Ala Arg Lys Leu Pro Arg Asn Phe Val
35 40 45
Val Asp Tyr Tyr Glu Thr Ser Ser Leu Cys Ser Gln Pro Ala Val Val
50 55 60
Phe Gln Thr Lys Arg Ser Lys Gln Val Cys Ala Asp Pro Ser Glu Ser
65 70 75 80
Trp Val Gln Glu Tyr Val Tyr Asp Leu Glu Leu Asn
85 90
<210> 35
<211> 309
<212> DNA
<213> Intelligent people
<400> 35
accatgaagg tctccgcggc agccctcgct gtcatcctca ttgctactgc cctctgcgct 60
cctgcatctg cctccccata ttcctcggac accacaccct gctgctttgc ctacattgcc 120
cgcccactgc cccgtgccca catcaaggag tatttctaca ccagtggcaa gtgctccaac 180
ccagcagtcg tctttgtcac ccgaaagaac cgccaagtgt gtgccaaccc agagaagaaa 240
tgggttcggg agtacatcaa ctctttggag atgagctagg atggagagtc cttgaacctg 300
aacttacac 309
<210> 36
<211> 91
<212> PRT
<213> Intelligent
<400> 36
Met Lys Val Ser Ala Ala Ala Leu Ala Val Ile Leu Ile Ala Thr Ala
1 5 10 15
Leu Cys Ala Pro Ala Ser Ala Ser Pro Tyr Ser Ser Asp Thr Thr Pro
20 25 30
Cys Cys Phe Ala Tyr Ile Ala Arg Pro Leu Pro Arg Ala His Ile Lys
35 40 45
Glu Tyr Phe Tyr Thr Ser Gly Lys Cys Ser Asn Pro Ala Val Val Phe
50 55 60
Val Thr Arg Lys Asn Arg Gln Val Cys Ala Asn Pro Glu Lys Lys Trp
65 70 75 80
Val Arg Glu Tyr Ile Asn Ser Leu Glu Met Ser
85 90
<210> 37
<211> 862
<212> DNA
<213> Intelligent
<400> 37
agagaggttg agaacaaccc agaaaccttc acctctcatg ctgaagctca cacccttgcc 60
ctccaagatg aaggtttctg cagcgcttct gtgcctgctg ctcatggcag ccactttcag 120
ccctcaggga cttgctcagc cagattcagt ttccattcca atcacctgct gctttaacgt 180
gatcaatagg aaaattccta tccagaggct ggagagctac acaagaatca ccaacatcca 240
atgtcccaag gaagctgtga tcttcaagac caaacggggc aaggaggtct gtgctgaccc 300
caaggagaga tgggtcaggg attccatgaa gcatctggac caaatatttc aaaatctgaa 360
gccatgagcc ttcatacatg gactgagagt cagagcttga agaaaagctt atttattttc 420
cccaacctcc cccaggtgca gtgtgacatt attttattat aacatccaca aagagattat 480
ttttaaataa tttaaagcat aatatttctt aaaaagtatt taattatatt taagttgttg 540
atgttttaac tctatctgtc atacatccta gtgaatgtaa aatgcaaaat cctggtgatg 600
tgttttttgt ttttgttttc ctgtgagctc aactaagttc acggcaaaat gtcattgttc 660
tccctcctac ctgtctgtag tgttgtgggg tcctcccatg gatcatcaag gtgaaacact 720
ttggtattct ttggcaatca gtgctcctgt aagtcaaatg tgtgctttgt actgctgttg 780
ttgaaattga tgttactgta tataactatg gaattttgaa aaaaaatttc aaaaagaaaa 840
aaatatatat aatttaaaac ta 862
<210> 38
<211> 99
<212> PRT
<213> Intelligent people
<400> 38
Met Lys Val Ser Ala Ala Leu Leu Cys Leu Leu Leu Met Ala Ala Thr
1 5 10 15
Phe Ser Pro Gln Gly Leu Ala Gln Pro Asp Ser Val Ser Ile Pro Ile
20 25 30
Thr Cys Cys Phe Asn Val Ile Asn Arg Lys Ile Pro Ile Gln Arg Leu
35 40 45
Glu Ser Tyr Thr Arg Ile Thr Asn Ile Gln Cys Pro Lys Glu Ala Val
50 55 60
Ile Phe Lys Thr Lys Arg Gly Lys Glu Val Cys Ala Asp Pro Lys Glu
65 70 75 80
Arg Trp Val Arg Asp Ser Met Lys His Leu Asp Gln Ile Phe Gln Asn
85 90 95
Leu Lys Pro
<210> 39
<211> 1332
<212> DNA
<213> Intelligent
<400> 39
agaaggaggc caggagttgt gagtttccaa gccccagctc actctgacca cttctctgcc 60
tgcccagcat catgaagggc cttgcagctg ccctccttgt cctcgtctgc accatggccc 120
tctgctcctg tgcacaagtt ggtaccaaca aagagctctg ctgcctcgtc tatacctcct 180
ggcagattcc acaaaagttc atagttgact attctgaaac cagcccccag tgccccaagc 240
caggtgtcat cctcctaacc aagagaggcc ggcagatctg tgctgacccc aataagaagt 300
gggtccagaa atacatcagc gacctgaagc tgaatgcctg aggggcctgg aagctgcgag 360
ggcccagtga acttggtggg cccaggaggg aacaggagcc tgagccaggg caatggccct 420
gccaccctgg aggctacctc ttctaagagt cccatctgct atgcccagcc acattaacta 480
actttaatct tagtttatgc atcatatttc attttgaaat tgatttctat tgttgagctg 540
cattatgaaa ttagtatttt ctctgacatc tcatgacatt gtctttatca tcctttcccc 600
tttcccttca actcttcgta cattcaatgc atggatcaat cagtgtgatt agctttctca 660
gcagacattg tgccatatgt atcaaatgac aaatctttat tgaatggttt tgctcagcac 720
caccttttaa tatattggca gtacttatta tataaaaggt aaaccagcat tctcactgtg 780
acgactctgt tgattttgtt tcactaatcg gaatcacaga ctgagaggaa ttctggggga 840
ggagtaggga aatatgaaaa ggggcagaaa cagcaagata gggaccaagt acttctacag 900
tcataccaga catttccctg gagatacttt cctgaaaagt tgaaacagac accattagtt 960
tataaaccat attgtaactg aaatgtgata gaaaaatttt ctacttaaat gaatatcaag 1020
atgacgctgc aatgcatatt tacgcacaca agctcatttt cataaatgaa gctttcctca 1080
gaatgatggc taacatctgt tgaggtctta ccaagtgctg ggttttgggc taagtactta 1140
tattagtaaa agtctagcaa atactgccca tagtctagca aggactcctt acctggaagt 1200
tgctgaaagc cttggtaatg ttatctttgt tctccactct gcttttgggg aggatgtttt 1260
ccatgactat acgagatgag gcttggggct gggtggccag agttagcaaa taaaaataca 1320
gaatggatac ta 1332
<210> 40
<211> 89
<212> PRT
<213> Intelligent people
<400> 40
Met Lys Gly Leu Ala Ala Ala Leu Leu Val Leu Val Cys Thr Met Ala
1 5 10 15
Leu Cys Ser Cys Ala Gln Val Gly Thr Asn Lys Glu Leu Cys Cys Leu
20 25 30
Val Tyr Thr Ser Trp Gln Ile Pro Gln Lys Phe Ile Val Asp Tyr Ser
35 40 45
Glu Thr Ser Pro Gln Cys Pro Lys Pro Gly Val Ile Leu Leu Thr Lys
50 55 60
Arg Gly Arg Gln Ile Cys Ala Asp Pro Asn Lys Lys Trp Val Gln Lys
65 70 75 80
Tyr Ile Ser Asp Leu Lys Leu Asn Ala
85
<210> 41
<211> 683
<212> DNA
<213> Intelligent
<400> 41
attcccagcc tcacatcact cacaccttgc atttcacccc tgcatcccag tcgccctgca 60
gcctcacaca gatcctgcac acacccagac agctggcgct cacacattca ccgttggcct 120
gcctctgttc accctccatg gccctgctac tggccctcag cctgctggtt ctctggactt 180
ccccagcccc aactctgagt ggcaccaatg atgctgaaga ctgctgcctg tctgtgaccc 240
agaaacccat ccctgggtac atcgtgagga acttccacta ccttctcatc aaggatggct 300
gcagggtgcc tgctgtagtg ttcaccacac tgaggggccg ccagctctgt gcacccccag 360
accagccctg ggtagaacgc atcatccaga gactgcagag gacctcagcc aagatgaagc 420
gccgcagcag ttaacctatg accgtgcaga gggagcccgg agtccgagtc aagcattgtg 480
aattattacc taacctgggg aaccgaggac cagaaggaag gaccaggctt ccagctcctc 540
tgcaccagac ctgaccagcc aggacagggc ctggggtgtg tgtgagtgtg agtgtgagcg 600
agagggtgag tgtggtcaga gtaaagctgc tccaccccca gattgcaatg ctaccaataa 660
agccgcctgg tgtttacaac taa 683
<210> 42
<211> 98
<212> PRT
<213> Intelligent
<400> 42
Met Ala Leu Leu Leu Ala Leu Ser Leu Leu Val Leu Trp Thr Ser Pro
1 5 10 15
Ala Pro Thr Leu Ser Gly Thr Asn Asp Ala Glu Asp Cys Cys Leu Ser
20 25 30
Val Thr Gln Lys Pro Ile Pro Gly Tyr Ile Val Arg Asn Phe His Tyr
35 40 45
Leu Leu Ile Lys Asp Gly Cys Arg Val Pro Ala Val Val Phe Thr Thr
50 55 60
Leu Arg Gly Arg Gln Leu Cys Ala Pro Pro Asp Gln Pro Trp Val Glu
65 70 75 80
Arg Ile Ile Gln Arg Leu Gln Arg Thr Ser Ala Lys Met Lys Arg Arg
85 90 95
Ser Ser
<210> 43
<211> 864
<212> DNA
<213> Intelligent people
<400> 43
acagaccccc aacttgcagc tgcccacctc accctcagct ctggcctctt actcaccctc 60
taccacagac atggctcagt cactggctct gagcctcctt atcctggttc tggcctttgg 120
catccccagg acccaaggca gtgatggagg ggctcaggac tgttgcctca agtacagcca 180
aaggaagatt cccgccaagg ttgtccgcag ctaccggaag caggaaccaa gcttaggctg 240
ctccatccca gctatcctgt tcttgccccg caagcgctct caggcagagc tatgtgcaga 300
cccaaaggag ctctgggtgc agcagctgat gcagcatctg gacaagacac catccccaca 360
gaaaccagcc cagggctgca ggaaggacag gggggcctcc aagactggca agaaaggaaa 420
gggctccaaa ggctgcaaga ggactgagcg gtcacagacc cctaaagggc catagcccag 480
tgagcagcct ggagccctgg agaccccacc agcctcacca gcgcttgaag cctgaaccca 540
agatgcaaga aggaggctat gctcaggggc cctggagcag ccaccccatg ctggccttgc 600
cacactcttt ctcctgcttt aaccacccca tctgcattcc cagctctacc ctgcatggct 660
gagctgccca cagcaggcca ggtccagaga gaccgaggag ggagagtctc ccagggagca 720
tgagaggagg cagcaggact gtccccttga aggagaatca tcaggaccct ggacctgata 780
cggctcccca gtacacccca cctcttcctt gtaaatatga tttataccta actgaataaa 840
aagctgttct gtcttcccac ccaa 864
<210> 44
<211> 134
<212> PRT
<213> Intelligent
<400> 44
Met Ala Gln Ser Leu Ala Leu Ser Leu Leu Ile Leu Val Leu Ala Phe
1 5 10 15
Gly Ile Pro Arg Thr Gln Gly Ser Asp Gly Gly Ala Gln Asp Cys Cys
20 25 30
Leu Lys Tyr Ser Gln Arg Lys Ile Pro Ala Lys Val Val Arg Ser Tyr
35 40 45
Arg Lys Gln Glu Pro Ser Leu Gly Cys Ser Ile Pro Ala Ile Leu Phe
50 55 60
Leu Pro Arg Lys Arg Ser Gln Ala Glu Leu Cys Ala Asp Pro Lys Glu
65 70 75 80
Leu Trp Val Gln Gln Leu Met Gln His Leu Asp Lys Thr Pro Ser Pro
85 90 95
Gln Lys Pro Ala Gln Gly Cys Arg Lys Asp Arg Gly Ala Ser Lys Thr
100 105 110
Gly Lys Lys Gly Lys Gly Ser Lys Gly Cys Lys Arg Thr Glu Arg Ser
115 120 125
Gln Thr Pro Lys Gly Pro
130
<210> 45
<211> 2761
<212> DNA
<213> Intelligent people
<400> 45
aaagaatttc tcaggctcaa aatccaatac aggagtgact tggaactcca ttctatcact 60
atgaagaaaa gtggtgttct tttcctcttg ggcatcatct tgctggttct gattggagtg 120
caaggaaccc cagtagtgag aaagggtcgc tgttcctgca tcagcaccaa ccaagggact 180
atccacctac aatccttgaa agaccttaaa caatttgccc caagcccttc ctgcgagaaa 240
attgaaatca ttgctacact gaagaatgga gttcaaacat gtctaaaccc agattcagca 300
gatgtgaagg aactgattaa aaagtgggag aaacaggtca gccaaaagaa aaagcaaaag 360
aatgggaaaa aacatcaaaa aaagaaagtt ctgaaagttc gaaaatctca acgttctcgt 420
caaaagaaga ctacataaga gaccacttca ccaataagta ttctgtgtta aaaatgttct 480
attttaatta taccgctatc attccaaagg aggatggcat ataatacaaa ggcttattaa 540
tttgactaga aaatttaaaa cattactctg aaattgtaac taaagttaga aagttgattt 600
taagaatcca aacgttaaga attgttaaag gctatgattg tctttgttct tctaccaccc 660
accagttgaa tttcatcatg cttaaggcca tgattttagc aatacccatg tctacacaga 720
tgttcaccca accacatccc actcacaaca gctgcctgga agagcagccc taggcttcca 780
cgtactgcag cctccagaga gtatctgagg cacatgtcag caagtcctaa gcctgttagc 840
atgctggtga gccaagcagt ttgaaattga gctggacctc accaagctgc tgtggccatc 900
aacctctgta tttgaatcag cctacaggcc tcacacacaa tgtgtctgag agattcatgc 960
tgattgttat tgggtatcac cactggagat caccagtgtg tggctttcag agcctccttt 1020
ctggctttgg aagccatgtg attccatctt gcccgctcag gctgaccact ttatttcttt 1080
ttgttcccct ttgcttcatt caagtcagct cttctccatc ctaccacaat gcagtgcctt 1140
tcttctctcc agtgcacctg tcatatgctc tgatttatct gagtcaactc ctttctcatc 1200
ttgtccccaa caccccacag aagtgctttc ttctcccaat tcatcctcac tcagtccagc 1260
ttagttcaag tcctgcctct taaataaacc tttttggaca cacaaattat cttaaaactc 1320
ctgtttcact tggttcagta ccacatgggt gaacactcaa tggttaacta attcttgggt 1380
gtttatccta tctctccaac cagattgtca gctccttgag ggcaagagcc acagtatatt 1440
tccctgtttc ttccacagtg cctaataata ctgtggaact aggttttaat aattttttaa 1500
ttgatgttgt tatgggcagg atggcaacca gaccattgtc tcagagcagg tgctggctct 1560
ttcctggcta ctccatgttg gctagcctct ggtaacctct tacttattat cttcaggaca 1620
ctcactacag ggaccaggga tgatgcaaca tccttgtctt tttatgacag gatgtttgct 1680
cagcttctcc aacaataaga agcacgtggt aaaacacttg cggatattct ggactgtttt 1740
taaaaaatat acagtttacc gaaaatcata taatcttaca atgaaaagga ctttatagat 1800
cagccagtga ccaacctttt cccaaccata caaaaattcc ttttcccgaa ggaaaagggc 1860
tttctcaata agcctcagct ttctaagatc taacaagata gccaccgaga tccttatcga 1920
aactcatttt aggcaaatat gagttttatt gtccgtttac ttgtttcaga gtttgtattg 1980
tgattatcaa ttaccacacc atctcccatg aagaaaggga acggtgaagt actaagcgct 2040
agaggaagca gccaagtcgg ttagtggaag catgattggt gcccagttag cctctgcagg 2100
atgtggaaac ctccttccag gggaggttca gtgaattgtg taggagaggt tgtctgtggc 2160
cagaatttaa acctatactc actttcccaa attgaatcac tgctcacact gctgatgatt 2220
tagagtgctg tccggtggag atcccacccg aacgtcttat ctaatcatga aactccctag 2280
ttccttcatg taacttccct gaaaaatcta agtgtttcat aaatttgaga gtctgtgacc 2340
cacttacctt gcatctcaca ggtagacagt atataactaa caaccaaaga ctacatattg 2400
tcactgacac acacgttata atcatttatc atatatatac atacatgcat acactctcaa 2460
agcaaataat ttttcacttc aaaacagtat tgacttgtat accttgtaat ttgaaatatt 2520
ttctttgtta aaatagaatg gtatcaataa atagaccatt aatcagaaaa cagatcttga 2580
ttttttttct cttgaatgta cccttcaact gttgaatgtt taatagtaaa tcttatatgt 2640
ccttatttac tttttagctt tctctcaaat aaagtgtaac actagttgag ataacacatg 2700
aaagctcttt aaagggtcga tcgggaacag gaaaaaaaac ctatggaaaa tatgacaaca 2760
c 2761
<210> 46
<211> 125
<212> PRT
<213> Intelligent people
<400> 46
Met Lys Lys Ser Gly Val Leu Phe Leu Leu Gly Ile Ile Leu Leu Val
1 5 10 15
Leu Ile Gly Val Gln Gly Thr Pro Val Val Arg Lys Gly Arg Cys Ser
20 25 30
Cys Ile Ser Thr Asn Gln Gly Thr Ile His Leu Gln Ser Leu Lys Asp
35 40 45
Leu Lys Gln Phe Ala Pro Ser Pro Ser Cys Glu Lys Ile Glu Ile Ile
50 55 60
Ala Thr Leu Lys Asn Gly Val Gln Thr Cys Leu Asn Pro Asp Ser Ala
65 70 75 80
Asp Val Lys Glu Leu Ile Lys Lys Trp Glu Lys Gln Val Ser Gln Lys
85 90 95
Lys Lys Gln Lys Asn Gly Lys Lys His Gln Lys Lys Lys Val Leu Lys
100 105 110
Val Arg Lys Ser Gln Arg Ser Arg Gln Lys Lys Thr Thr
115 120 125
<210> 47
<211> 1175
<212> DNA
<213> Intelligent
<400> 47
gagacattcc tcaattgctt agacatattc tgagcctaca gcagaggaac ctccagtctc 60
agcaccatga atcaaactgc cattctgatt tgctgcctta tctttctgac tctaagtggc 120
attcaaggag tacctctctc tagaactgta cgctgtacct gcatcagcat tagtaatcaa 180
cctgttaatc caaggtcttt agaaaaactt gaaattattc ctgcaagcca attttgtcca 240
cgtgttgaga tcattgctac aatgaaaaag aagggtgaga agagatgtct gaatccagaa 300
tcgaaggcca tcaagaattt actgaaagca gttagcaagg aaaggtctaa aagatctcct 360
taaaaccaga ggggagcaaa atcgatgcag tgcttccaag gatggaccac acagaggctg 420
cctctcccat cacttcccta catggagtat atgtcaagcc ataattgttc ttagtttgca 480
gttacactaa aaggtgacca atgatggtca ccaaatcagc tgctactact cctgtaggaa 540
ggttaatgtt catcatccta agctattcag taataactct accctggcac tataatgtaa 600
gctctactga ggtgctatgt tcttagtgga tgttctgacc ctgcttcaaa tatttccctc 660
acctttccca tcttccaagg gtactaagga atctttctgc tttggggttt atcagaattc 720
tcagaatctc aaataactaa aaggtatgca atcaaatctg ctttttaaag aatgctcttt 780
acttcatgga cttccactgc catcctccca aggggcccaa attctttcag tggctaccta 840
catacaattc caaacacata caggaaggta gaaatatctg aaaatgtatg tgtaagtatt 900
cttatttaat gaaagactgt acaaagtaga agtcttagat gtatatattt cctatattgt 960
tttcagtgta catggaataa catgtaatta agtactatgt atcaatgagt aacaggaaaa 1020
ttttaaaaat acagatagat atatgctctg catgttacat aagataaatg tgctgaatgg 1080
ttttcaaaat aaaaatgagg tactctcctg gaaatattaa gaaagactat ctaaatgttg 1140
aaagatcaaa aggttaataa agtaattata actaa 1175
<210> 48
<211> 98
<212> PRT
<213> Intelligent
<400> 48
Met Asn Gln Thr Ala Ile Leu Ile Cys Cys Leu Ile Phe Leu Thr Leu
1 5 10 15
Ser Gly Ile Gln Gly Val Pro Leu Ser Arg Thr Val Arg Cys Thr Cys
20 25 30
Ile Ser Ile Ser Asn Gln Pro Val Asn Pro Arg Ser Leu Glu Lys Leu
35 40 45
Glu Ile Ile Pro Ala Ser Gln Phe Cys Pro Arg Val Glu Ile Ile Ala
50 55 60
Thr Met Lys Lys Lys Gly Glu Lys Arg Cys Leu Asn Pro Glu Ser Lys
65 70 75 80
Ala Ile Lys Asn Leu Leu Lys Ala Val Ser Lys Glu Arg Ser Lys Arg
85 90 95
Ser Pro
<210> 49
<211> 1479
<212> DNA
<213> Intelligent people
<400> 49
gttcagcatt tctactcctt ccaagaagag cagcaaagct gaagtagcag cagcagcacc 60
agcagcaaca gcaaaaaaca aacatgagtg tgaagggcat ggctatagcc ttggctgtga 120
tattgtgtgc tacagttgtt caaggcttcc ccatgttcaa aagaggacgc tgtctttgca 180
taggccctgg ggtaaaagca gtgaaagtgg cagatattga gaaagcctcc ataatgtacc 240
caagtaacaa ctgtgacaaa atagaagtga ttattaccct gaaagaaaat aaaggacaac 300
gatgcctaaa tcccaaatcg aagcaagcaa ggcttataat caaaaaagtt gaaagaaaga 360
atttttaaaa atatcaaaac atatgaagtc ctggaaaaga gcatctgaaa aacctagaac 420
aagtttaact gtgactactg aaatgacaag aattctacag taggaaactg agacttttct 480
atggttttgt gactttcaac ttttgtacag ttatgtgaag gatgaaaggt gggtgaaagg 540
accaaaaaca gaaatacagt cttcctgaat gaatgacaat cagaattcca ctgcccaaag 600
gagtccaaca attaaatgga tttctaggaa aagctacctt aagaaaggct ggttaccatc 660
ggagtttaca aagtgctttc acgttcttac ttgttgcatt atacattcat gcatttctag 720
gctagagaac cttctagatt tgatgcttac aactattctg ttgtgactat gagaacattt 780
ctgtctctag aagtcatctg tctgtattga tctttatgct atattactat ctgtggttac 840
ggtggagaca ttgacattat tactggagtc aagcccttat aagtcaaaag catctatgtg 900
tcgtaaaaca ttcctcaaac attttttcat gcaaatacac acttctttcc ccaaacatca 960
tgtagcacat caatatgtag ggagacattc ttatgcatca tttggtttgt tttataacca 1020
attcattaaa tgtaattcat aaaatgtact atgaaaaaaa ttatacgcta tgggatactg 1080
gcaaaagtgc acatatttca taaccaaatt agtagcacca gtcttaattt gatgtttttc 1140
aacttttatt cattgagatg ttttgaagca attaggatat gtgtgtttac tgtacttttt 1200
gttttgatcc gtttgtataa atgatagcaa tatcttggac acatctgaaa tacaaaatgt 1260
ttttgtctac caaagaaaaa tgttgaaaaa taagcaaatg tatacctagc aatcactttt 1320
actttttgta attctgtctc ttagaaaaat acataatcta atcaatttct ttgttcatgc 1380
ctatatactg taaaatttag gtatactcaa gactagttta aagaatcaaa gtcatttttt 1440
tctctaataa actaccacaa cctttctttt ttaaaaaaa 1479
<210> 50
<211> 94
<212> PRT
<213> Intelligent people
<400> 50
Met Ser Val Lys Gly Met Ala Ile Ala Leu Ala Val Ile Leu Cys Ala
1 5 10 15
Thr Val Val Gln Gly Phe Pro Met Phe Lys Arg Gly Arg Cys Leu Cys
20 25 30
Ile Gly Pro Gly Val Lys Ala Val Lys Val Ala Asp Ile Glu Lys Ala
35 40 45
Ser Ile Met Tyr Pro Ser Asn Asn Cys Asp Lys Ile Glu Val Ile Ile
50 55 60
Thr Leu Lys Glu Asn Lys Gly Gln Arg Cys Leu Asn Pro Lys Ser Lys
65 70 75 80
Gln Ala Arg Leu Ile Ile Lys Lys Val Glu Arg Lys Asn Phe
85 90
<210> 51
<211> 1219
<212> DNA
<213> Intelligent people
<400> 51
gagaagatgt ttgaaaaaac tgactctgct aatgagcctg gactcagagc tcaagtctga 60
actctacctc cagacagaat gaagttcatc tcgacatctc tgcttctcat gctgctggtc 120
agcagcctct ctccagtcca aggtgttctg gaggtctatt acacaagctt gaggtgtaga 180
tgtgtccaag agagctcagt ctttatccct agacgcttca ttgatcgaat tcaaatcttg 240
ccccgtggga atggttgtcc aagaaaagaa atcatagtct ggaagaagaa caagtcaatt 300
gtgtgtgtgg accctcaagc tgaatggata caaagaatga tggaagtatt gagaaaaaga 360
agttcttcaa ctctaccagt tccagtgttt aagagaaaga ttccctgatg ctgatatttc 420
cactaagaac acctgcattc ttcccttatc cctgctctgg attttagttt tgtgcttagt 480
taaatctttt ccaggaaaaa gaacttcccc atacaaataa gcatgagact atgtaaaaat 540
aaccttgcag aagctgatgg ggcaaactca agcttcttca ctcacagcac cctatataca 600
cttggagttt gcattcttat tcatcaggga ggaaagtttc tttgaaaata gttattcagt 660
tataagtaat acaggattat tttgattata tacttgttgt ttaatgttta aaatttctta 720
gaaaacaatg gaatgagaat ttaagcctca aatttgaaca tgtggcttga attaagaaga 780
aaattatggc atatattaaa agcaggcttc tatgaaagac tcaaaaagct gcctgggagg 840
cagatggaac ttgagcctgt caagaggcaa aggaatccat gtagtagata tcctctgctt 900
aaaaactcac tacggaggag aattaagtcc tacttttaaa gaatttcttt ataaaattta 960
ctgtctaaga ttaatagcat tcgaagatcc ccagacttca tagaatactc agggaaagca 1020
tttaaagggt gatgtacaca tgtatccttt cacacatttg ccttgacaaa cttctttcac 1080
tcacatcttt ttcactgact ttttttgtgg ggggcggggc cggggggact ctggtatcta 1140
attctttaat gattcctata aatctaatga cattcaataa agttgagcaa acattttact 1200
taaaaaaaaa aaaaaaaaa 1219
<210> 52
<211> 109
<212> PRT
<213> Intelligent people
<400> 52
Met Lys Phe Ile Ser Thr Ser Leu Leu Leu Met Leu Leu Val Ser Ser
1 5 10 15
Leu Ser Pro Val Gln Gly Val Leu Glu Val Tyr Tyr Thr Ser Leu Arg
20 25 30
Cys Arg Cys Val Gln Glu Ser Ser Val Phe Ile Pro Arg Arg Phe Ile
35 40 45
Asp Arg Ile Gln Ile Leu Pro Arg Gly Asn Gly Cys Pro Arg Lys Glu
50 55 60
Ile Ile Val Trp Lys Lys Asn Lys Ser Ile Val Cys Val Asp Pro Gln
65 70 75 80
Ala Glu Trp Ile Gln Arg Met Met Glu Val Leu Arg Lys Arg Ser Ser
85 90 95
Ser Thr Leu Pro Val Pro Val Phe Lys Arg Lys Ile Pro
100 105
<210> 53
<211> 1060
<212> DNA
<213> Intelligent people
<400> 53
cggctcccgc gccgcctccc ctcgcgcccg agcttcgagc caagcagcgt cctggggagc 60
gcgtcatggc cttaccagtg accgccttgc tcctgccgct ggccttgctg ctccacgccg 120
ccaggccgag ccagttccgg gtgtcgccgc tggatcggac ctggaacctg ggcgagacag 180
tggagctgaa gtgccaggtg ctgctgtcca acccgacgtc gggctgctcg tggctcttcc 240
agccgcgcgg cgccgccgcc agtcccacct tcctcctata cctctcccaa aacaagccca 300
aggcggccga ggggctggac acccagcggt tctcgggcaa gaggttgggg gacaccttcg 360
tcctcaccct gagcgacttc cgccgagaga acgagggcta ctatttctgc tcggccctga 420
gcaactccat catgtacttc agccacttcg tgccggtctt cctgccagcg aagcccacca 480
cgacgccagc gccgcgacca ccaacaccgg cgcccaccat cgcgtcgcag cccctgtccc 540
tgcgcccaga ggcgtgccgg ccagcggcgg ggggcgcagt gcacacgagg gggctggact 600
tcgcctgtga tatctacatc tgggcgccct tggccgggac ttgtggggtc cttctcctgt 660
cactggttat caccctttac tgcaaccaca ggaaccgaag acgtgtttgc aaatgtcccc 720
ggcctgtggt caaatcggga gacaagccca gcctttcggc gagatacgtc taaccctgtg 780
caacagccac tacattactt caaactgaga tccttccttt tgagggagca agtccttccc 840
tttcattttt tccagtcttc ctccctgtgt attcattctc atgattatta ttttagtggg 900
ggcggggtgg gaaagattac tttttcttta tgtgtttgac gggaaacaaa actaggtaaa 960
atctacagta caccacaagg gtcacaatac tgttgtgcgc acatcgcggt agggcgtgga 1020
aaggggcagg ccagagctac ccgcagagtt ctcagaatca 1060
<210> 54
<211> 235
<212> PRT
<213> Intelligent
<400> 54
Met Ala Leu Pro Val Thr Ala Leu Leu Leu Pro Leu Ala Leu Leu Leu
1 5 10 15
His Ala Ala Arg Pro Ser Gln Phe Arg Val Ser Pro Leu Asp Arg Thr
20 25 30
Trp Asn Leu Gly Glu Thr Val Glu Leu Lys Cys Gln Val Leu Leu Ser
35 40 45
Asn Pro Thr Ser Gly Cys Ser Trp Leu Phe Gln Pro Arg Gly Ala Ala
50 55 60
Ala Ser Pro Thr Phe Leu Leu Tyr Leu Ser Gln Asn Lys Pro Lys Ala
65 70 75 80
Ala Glu Gly Leu Asp Thr Gln Arg Phe Ser Gly Lys Arg Leu Gly Asp
85 90 95
Thr Phe Val Leu Thr Leu Ser Asp Phe Arg Arg Glu Asn Glu Gly Tyr
100 105 110
Tyr Phe Cys Ser Ala Leu Ser Asn Ser Ile Met Tyr Phe Ser His Phe
115 120 125
Val Pro Val Phe Leu Pro Ala Lys Pro Thr Thr Thr Pro Ala Pro Arg
130 135 140
Pro Pro Thr Pro Ala Pro Thr Ile Ala Ser Gln Pro Leu Ser Leu Arg
145 150 155 160
Pro Glu Ala Cys Arg Pro Ala Ala Gly Gly Ala Val His Thr Arg Gly
165 170 175
Leu Asp Phe Ala Cys Asp Ile Tyr Ile Trp Ala Pro Leu Ala Gly Thr
180 185 190
Cys Gly Val Leu Leu Leu Ser Leu Val Ile Thr Leu Tyr Cys Asn His
195 200 205
Arg Asn Arg Arg Arg Val Cys Lys Cys Pro Arg Pro Val Val Lys Ser
210 215 220
Gly Asp Lys Pro Ser Leu Ser Ala Arg Tyr Val
225 230 235
<210> 55
<211> 3207
<212> DNA
<213> Intelligent people
<400> 55
agccagctgc cgtctgcgct ttgcaaagca tgcagttagg ggagcagctc ttggtgagct 60
cagtgaacct gcctggcgcg cacttctacc cgctggagag tgcgcgaggc ggcagcggcg 120
ggagcgctgg ccacctcccc agcgcggccc cctctcctca gaagttggac ttagacaaag 180
cgtccaagaa gttttccggc agtctctcct gcgaggcggt gagcggggag cccgcagccg 240
ccagcgcagg ggcccccgcg gccatgctta gtgacaccga cgccggggac gcatttgcca 300
gcgctgcggc agtggccaag ccggggcccc cggacggccg caagggctcc ccctgcgggg 360
aggaggagct gccctccgcc gctgcagccg ccgccgccgc cgccgccgcg gctgcggcca 420
ctgcgcgcta ctccatggac agcctgagct ccgagcggta ctacctccag tcccccggtc 480
ctcaggggtc ggagctggct gcgccctgct cactcttccc gtaccaggcg gcggctgggg 540
cgccccacgg acctgtgtac ccggctccta acggggcgcg ctacccctac ggctccatgc 600
tgccccccgg cggcttcccc gcggctgtgt gcccacccgg gagggcgcag ttcggcccag 660
gagccggtgc gggcagtggc gcgggcggta gcagcggcgg gggcggcggc ccgggcacct 720
atcagtacag ccagggggct ccgctctacg ggccgtaccc tggagccgca gcggcgggat 780
cttgcggagg actggggggc ctgggggttc caggttctgg cttccgtgcc cacgtctacc 840
tgtgcaaccg gcctctgtgg ctcaaattcc accgccacca aactgagatg atcattacga 900
aacagggcag gcgcatgttt cctttcttga gcttcaacat aaacggactc aatcccactg 960
cccactacaa tgtgttcgta gaggtggtgc tggcggaccc caaccactgg cgcttccagg 1020
ggggcaaatg ggtgacctgt ggcaaagccg acaataacat gcagggcaac aaaatgtatg 1080
ttcacccaga gtctcctaat actggttccc actggatgag acaggagatt tcattcggga 1140
aattaaaact caccaataac aaaggcgcaa ataacaacaa cacccagatg atagtcttac 1200
aatccttaca caaataccaa ccccgactgc atattgttga agttacagag gatggcgtgg 1260
aggacttgaa tgagccctca aagacccaga cttttacctt ctcagaaacg caattcattg 1320
cagtgactgc ctaccaaaac accgatatta ctcaactaaa gattgatcat aacccctttg 1380
caaaaggctt cagagacaac tatgattcat cccatcagat tgtccctgga ggtcggtacg 1440
gcgttcaatc cttcttcccg gagccctttg tcaacacttt acctcaagcc cgctattata 1500
atggcgagag aaccgtgcca cagaccaacg gcctcctttc accccaacag agcgaagagg 1560
tggccaaccc tccccagcgg tggcttgtca cgcctgtcca gcaacctggg accaacaaac 1620
tagacatcag ttcctatgaa tctgaatata cttctagcac attgctccca tatggcatta 1680
aatccttgcc ccttcagaca tcccatgccc tggggtatta cccagaccca acctttcctg 1740
caatggcagg gtggggaggt cgaggttctt accagaggaa gatggcagct ggactaccat 1800
ggacctccag aacaagcccc actgtgttct ctgaagatca gctctccaag gagaaagtga 1860
aagaggaaat tggctcttct tggatagaga cacccccttc catcaaatct ctagattcca 1920
atgattcagg agtatacacc agtgcttgta agcgaaggcg gctgtctcct agcaactcca 1980
gtaatgaaaa ttcaccctcc ataaagtgtg aggacattaa tgctgaagag tatagtaaag 2040
acacctcaaa aggcatggga gggtattatg ctttttacac aactccctaa agagttattt 2100
taacctcaaa aattagctaa ctttttgcag atggacttgg tggtgttttt tgttgtcttc 2160
tttgcctagg ttgccaaaaa gatgtttgcc ttccaccttg atgcatcctg ttttgtgcaa 2220
ttctctaaaa gaaggtgcca aagctttttg attgctgcag gtaactgaaa caaacctagc 2280
atttttaaaa aataagatta atggaagact ttaaggtatt ttaaaattcg aagggtatcc 2340
aaggttctgt atttatttat tggggagaca ctaacccttc aaagaagcag gctgtgaaca 2400
ttgggtgccc agtgctatca gatgagttaa aacctttgat tctcatttct atttgtaaat 2460
tcttaagcaa atagaagccg agtgttaagg tgttttgctt ctgaaagagg gctgtgcctt 2520
ccgtttcaga aggagacatt ttgctgttac attctgccag gggcaaaaga tactaggccc 2580
aggagtcaag aaaagctttt gtgaaagtga tagtttcacc tgactttgat tccttaaccc 2640
ccggcttttg gaacaagcca tgtttgccct agtccaggat tgcctcactt gagacttgct 2700
aggcctctgc tgtgtgctgg ggtggccagt gggactcagg agagagcaag ctaaggagtc 2760
accaaaaaaa aaaaaaaaaa aaagggagaa tttaaaagtg tacagttgtg tgtttagata 2820
cactatagaa taatgtggta tatattgtac aaatagtcta cataggtgtc tgggataatg 2880
taaaactggt gctttggctt tgtaaagaat ttgcaaatca cttaacagct gcaggggcaa 2940
ggggagagtt tcatcatccc catgatattt gggaatattc tgtttacttc ttagatagtt 3000
aagaatgtat tcagctacta tgtactaact tgaaccgtgt ttaaggaaaa ctcctatttc 3060
atcctcttct tgcgccatcc cctctcccta acttggtaat gtgaagaaac taaaacctga 3120
taccacagct cctataggca ttttagagat cttggatttt tatgtacagt cttagtcatt 3180
tttaataaat gtggttcagt aagggaa 3207
<210> 56
<211> 686
<212> PRT
<213> Intelligent
<400> 56
Met Gln Leu Gly Glu Gln Leu Leu Val Ser Ser Val Asn Leu Pro Gly
1 5 10 15
Ala His Phe Tyr Pro Leu Glu Ser Ala Arg Gly Gly Ser Gly Gly Ser
20 25 30
Ala Gly His Leu Pro Ser Ala Ala Pro Ser Pro Gln Lys Leu Asp Leu
35 40 45
Asp Lys Ala Ser Lys Lys Phe Ser Gly Ser Leu Ser Cys Glu Ala Val
50 55 60
Ser Gly Glu Pro Ala Ala Ala Ser Ala Gly Ala Pro Ala Ala Met Leu
65 70 75 80
Ser Asp Thr Asp Ala Gly Asp Ala Phe Ala Ser Ala Ala Ala Val Ala
85 90 95
Lys Pro Gly Pro Pro Asp Gly Arg Lys Gly Ser Pro Cys Gly Glu Glu
100 105 110
Glu Leu Pro Ser Ala Ala Ala Ala Ala Ala Ala Ala Ala Ala Ala Ala
115 120 125
Ala Ala Thr Ala Arg Tyr Ser Met Asp Ser Leu Ser Ser Glu Arg Tyr
130 135 140
Tyr Leu Gln Ser Pro Gly Pro Gln Gly Ser Glu Leu Ala Ala Pro Cys
145 150 155 160
Ser Leu Phe Pro Tyr Gln Ala Ala Ala Gly Ala Pro His Gly Pro Val
165 170 175
Tyr Pro Ala Pro Asn Gly Ala Arg Tyr Pro Tyr Gly Ser Met Leu Pro
180 185 190
Pro Gly Gly Phe Pro Ala Ala Val Cys Pro Pro Gly Arg Ala Gln Phe
195 200 205
Gly Pro Gly Ala Gly Ala Gly Ser Gly Ala Gly Gly Ser Ser Gly Gly
210 215 220
Gly Gly Gly Pro Gly Thr Tyr Gln Tyr Ser Gln Gly Ala Pro Leu Tyr
225 230 235 240
Gly Pro Tyr Pro Gly Ala Ala Ala Ala Gly Ser Cys Gly Gly Leu Gly
245 250 255
Gly Leu Gly Val Pro Gly Ser Gly Phe Arg Ala His Val Tyr Leu Cys
260 265 270
Asn Arg Pro Leu Trp Leu Lys Phe His Arg His Gln Thr Glu Met Ile
275 280 285
Ile Thr Lys Gln Gly Arg Arg Met Phe Pro Phe Leu Ser Phe Asn Ile
290 295 300
Asn Gly Leu Asn Pro Thr Ala His Tyr Asn Val Phe Val Glu Val Val
305 310 315 320
Leu Ala Asp Pro Asn His Trp Arg Phe Gln Gly Gly Lys Trp Val Thr
325 330 335
Cys Gly Lys Ala Asp Asn Asn Met Gln Gly Asn Lys Met Tyr Val His
340 345 350
Pro Glu Ser Pro Asn Thr Gly Ser His Trp Met Arg Gln Glu Ile Ser
355 360 365
Phe Gly Lys Leu Lys Leu Thr Asn Asn Lys Gly Ala Asn Asn Asn Asn
370 375 380
Thr Gln Met Ile Val Leu Gln Ser Leu His Lys Tyr Gln Pro Arg Leu
385 390 395 400
His Ile Val Glu Val Thr Glu Asp Gly Val Glu Asp Leu Asn Glu Pro
405 410 415
Ser Lys Thr Gln Thr Phe Thr Phe Ser Glu Thr Gln Phe Ile Ala Val
420 425 430
Thr Ala Tyr Gln Asn Thr Asp Ile Thr Gln Leu Lys Ile Asp His Asn
435 440 445
Pro Phe Ala Lys Gly Phe Arg Asp Asn Tyr Asp Ser Ser His Gln Ile
450 455 460
Val Pro Gly Gly Arg Tyr Gly Val Gln Ser Phe Phe Pro Glu Pro Phe
465 470 475 480
Val Asn Thr Leu Pro Gln Ala Arg Tyr Tyr Asn Gly Glu Arg Thr Val
485 490 495
Pro Gln Thr Asn Gly Leu Leu Ser Pro Gln Gln Ser Glu Glu Val Ala
500 505 510
Asn Pro Pro Gln Arg Trp Leu Val Thr Pro Val Gln Gln Pro Gly Thr
515 520 525
Asn Lys Leu Asp Ile Ser Ser Tyr Glu Ser Glu Tyr Thr Ser Ser Thr
530 535 540
Leu Leu Pro Tyr Gly Ile Lys Ser Leu Pro Leu Gln Thr Ser His Ala
545 550 555 560
Leu Gly Tyr Tyr Pro Asp Pro Thr Phe Pro Ala Met Ala Gly Trp Gly
565 570 575
Gly Arg Gly Ser Tyr Gln Arg Lys Met Ala Ala Gly Leu Pro Trp Thr
580 585 590
Ser Arg Thr Ser Pro Thr Val Phe Ser Glu Asp Gln Leu Ser Lys Glu
595 600 605
Lys Val Lys Glu Glu Ile Gly Ser Ser Trp Ile Glu Thr Pro Pro Ser
610 615 620
Ile Lys Ser Leu Asp Ser Asn Asp Ser Gly Val Tyr Thr Ser Ala Cys
625 630 635 640
Lys Arg Arg Arg Leu Ser Pro Ser Asn Ser Ser Asn Glu Asn Ser Pro
645 650 655
Ser Ile Lys Cys Glu Asp Ile Asn Ala Glu Glu Tyr Ser Lys Asp Thr
660 665 670
Ser Lys Gly Met Gly Gly Tyr Tyr Ala Phe Tyr Thr Thr Pro
675 680 685
<210> 57
<211> 884
<212> DNA
<213> Intelligent
<400> 57
cagccacaat gaggaactcc tatagatttc tggcatcctc tctctcagtt gtcgtttctc 60
tcctgctaat tcctgaagat gtctgtgaaa aaattattgg aggaaatgaa gtaactcctc 120
attcaagacc ctacatggtc ctacttagtc ttgacagaaa aaccatctgt gctggggctt 180
tgattgcaaa agactgggtg ttgactgcag ctcactgtaa cttgaacaaa aggtcccagg 240
tcattcttgg ggctcactca ataaccaggg aagagccaac aaaacagata atgcttgtta 300
agaaagagtt tccctatcca tgctatgacc cagccacacg cgaaggtgac cttaaacttt 360
tacagctgac ggaaaaagca aaaattaaca aatatgtgac tatccttcat ctacctaaaa 420
agggggatga tgtgaaacca ggaaccatgt gccaagttgc agggtggggc aggactcaca 480
atagtgcatc ttggtccgat actctgagag aagtcaatat caccatcata gacagaaaag 540
tctgcaatga tcgaaatcac tataatttta accctgtgat tggaatgaat atggtttgtg 600
ctggaagcct ccgaggtgga agagactcgt gcaatggaga ttctggaagc cctttgttgt 660
gcgagggtgt tttccgaggg gtcacttcct ttggccttga aaataaatgc ggagaccctc 720
gtgggcctgg tgtctatatt cttctctcaa agaaacacct caactggata attatgacta 780
tcaagggagc agtttaaata accgtttcct ttcatttact gtggcttctt aatcttttca 840
caaataaaat caatttgcat gactgtaaaa aaaaaaaaaa aaaa 884
<210> 58
<211> 262
<212> PRT
<213> Intelligent
<400> 58
Met Arg Asn Ser Tyr Arg Phe Leu Ala Ser Ser Leu Ser Val Val Val
1 5 10 15
Ser Leu Leu Leu Ile Pro Glu Asp Val Cys Glu Lys Ile Ile Gly Gly
20 25 30
Asn Glu Val Thr Pro His Ser Arg Pro Tyr Met Val Leu Leu Ser Leu
35 40 45
Asp Arg Lys Thr Ile Cys Ala Gly Ala Leu Ile Ala Lys Asp Trp Val
50 55 60
Leu Thr Ala Ala His Cys Asn Leu Asn Lys Arg Ser Gln Val Ile Leu
65 70 75 80
Gly Ala His Ser Ile Thr Arg Glu Glu Pro Thr Lys Gln Ile Met Leu
85 90 95
Val Lys Lys Glu Phe Pro Tyr Pro Cys Tyr Asp Pro Ala Thr Arg Glu
100 105 110
Gly Asp Leu Lys Leu Leu Gln Leu Met Glu Lys Ala Lys Ile Asn Lys
115 120 125
Tyr Val Thr Ile Leu His Leu Pro Lys Lys Gly Asp Asp Val Lys Pro
130 135 140
Gly Thr Met Cys Gln Val Ala Gly Trp Gly Arg Thr His Asn Ser Ala
145 150 155 160
Ser Trp Ser Asp Thr Leu Arg Glu Val Asn Ile Thr Ile Ile Asp Arg
165 170 175
Lys Val Cys Asn Asp Arg Asn His Tyr Asn Phe Asn Pro Val Ile Gly
180 185 190
Met Asn Met Val Cys Ala Gly Ser Leu Arg Gly Gly Arg Asp Ser Cys
195 200 205
Asn Gly Asp Ser Gly Ser Pro Leu Leu Cys Glu Gly Val Phe Arg Gly
210 215 220
Val Thr Ser Phe Gly Leu Glu Asn Lys Cys Gly Asp Pro Arg Gly Pro
225 230 235 240
Gly Val Tyr Ile Leu Leu Ser Lys Lys His Leu Asn Trp Ile Ile Met
245 250 255
Thr Ile Lys Gly Ala Val
260
<210> 59
<211> 2583
<212> DNA
<213> Intelligent people
<400> 59
agtgacagcg gcccgctgga gaggaagccc gagagctgcc gcgcgcctgc cggacgaggg 60
cgtagaagcc aggcgtcaga gcccgggctc cggtggggtc ccccacccgg ccctcgggtc 120
ccccgccccc tgctccctgc ccatcccagc ccacgcgacc ctctcgcgcg cggaggggcg 180
ggtcctcgac ggctacggga aggtgccagc ccgccccgga tgggcatcgt ggagccgggt 240
tgcggagaca tgctgacggg caccgagccg atgccgggga gcgacgaggg ccgggcgcct 300
ggcgccgacc cgcagcaccg ctacttctac ccggagccgg gcgcgcagga cgcggacgag 360
cgtcgcgggg gcggcagcct ggggtctccc tacccggggg gcgccttggt gcccgccccg 420
ccgagccgct tccttggagc ctacgcctac ccgccgcgac cccaggcggc cggcttcccc 480
ggcgcgggcg agtccttccc gccgcccgcg gacgccgagg gctaccagcc gggcgagggc 540
tacgccgccc cggacccgcg cgccgggctc tacccggggc cgcgtgagga ctacgcgcta 600
cccgcgggac tggaggtgtc ggggaaactg agggtcgcgc tcaacaacca cctgttgtgg 660
tccaagttta atcagcacca gacagagatg atcatcacca agcagggacg gcggatgttc 720
ccattcctgt catttactgt ggccgggctg gagcccacca gccactacag gatgtttgtg 780
gacgtggtct tggtggacca gcaccactgg cggtaccaga gcggcaagtg ggtgcagtgt 840
ggaaaggccg agggcagcat gccaggaaac cgcctgtacg tccacccgga ctcccccaac 900
acaggagcgc actggatgcg ccaggaagtt tcatttggga aactaaagct cacaaacaac 960
aagggggcgt ccaacaatgt gacccagatg attgtgctcc agtccctcca taagtaccag 1020
ccccggctgc atatcgttga ggtgaacgac ggagagccag aggcagcctg caacgcttcc 1080
aacacgcata tctttacttt ccaagaaacc cagttcattg ccgtgactgc ctaccagaat 1140
gccgagatta ctcagctgaa aattgataat aacccctttg ccaaaggatt ccgggagaac 1200
tttgagtcca tgtacacatc tgttgacacc agcatcccct ccccgcctgg acccaactgt 1260
caattccttg ggggagatca ctactctcct ctcctaccca accagtatcc tgttcccagc 1320
cgcttctacc ccgaccttcc tggccaggcg aaggatgtgg ttccccaggc ttactggctg 1380
ggggcccccc gggaccacag ctatgaggct gagtttcgag cagtcagcat gaagcctgca 1440
ttcttgccct ctgcccctgg gcccaccatg tcctactacc gaggccagga ggtcctggca 1500
cctggagctg gctggcctgt ggcaccccag taccctccca agatgggccc ggccagctgg 1560
ttccgcccta tgcggactct gcccatggaa cccggccctg gaggctcaga gggacgggga 1620
ccagaggacc agggtccccc cttggtgtgg actgagattg cccccatccg gccggaatcc 1680
agtgattcag gactgggcga aggagactct aagaggaggc gcgtgtcccc ctatccttcc 1740
agtggtgaca gctcctcccc tgctggggcc ccttctcctt ttgataagga agctgaagga 1800
cagttttata actattttcc caactgagca gatgacatga tgaaaggaac agaaacagtg 1860
ttattaggtt ggaggacacc gactaatttg ggaaacggat gaaggactga gaaggccccc 1920
gctccctctg gcccttctct gtttagtagt tggttgggga agtggggctc aagaaggatt 1980
ttggggttca ccagatgctt cctggcccac gatgaaacct gagaggggtg tccccttgcc 2040
ccatcctctg ccctaactac agtcgtttac ctggtgctgc gtcttgcttt tggtttccag 2100
ctggagaaaa gaagacaaga aagtcttggg catgaaggag ctttttgcat ctagtgggtg 2160
ggaggggtca ggtgtgggac atgggagcag gagactccac tttcttcctt tgtacagtaa 2220
ctttcaacct tttcgttggc atgtgtgtta atccctgatc caaaaagaac aaatacacgt 2280
atgttataac catcagcccg ccagggtcag ggaaaggact cacctgactt tggacagctg 2340
gcctgggctc cccctgctca aacacagtgg ggatcagaga aaaggggctg gaaagggggg 2400
aatggcccac atctcaagaa gcaagatatt gtttgtggtg gttgtgtgtg ggtgtgtgtt 2460
ttttcttttt ctttcttttt attttttttg aatgggggag gctatttatt gtactgagag 2520
tggtgtctgg atatattcct tttgtcttca tcactttctg aaaataaaca taaaactgtt 2580
gaa 2583
<210> 60
<211> 535
<212> PRT
<213> Intelligent
<400> 60
Met Gly Ile Val Glu Pro Gly Cys Gly Asp Met Leu Thr Gly Thr Glu
1 5 10 15
Pro Met Pro Gly Ser Asp Glu Gly Arg Ala Pro Gly Ala Asp Pro Gln
20 25 30
His Arg Tyr Phe Tyr Pro Glu Pro Gly Ala Gln Asp Ala Asp Glu Arg
35 40 45
Arg Gly Gly Gly Ser Leu Gly Ser Pro Tyr Pro Gly Gly Ala Leu Val
50 55 60
Pro Ala Pro Pro Ser Arg Phe Leu Gly Ala Tyr Ala Tyr Pro Pro Arg
65 70 75 80
Pro Gln Ala Ala Gly Phe Pro Gly Ala Gly Glu Ser Phe Pro Pro Pro
85 90 95
Ala Asp Ala Glu Gly Tyr Gln Pro Gly Glu Gly Tyr Ala Ala Pro Asp
100 105 110
Pro Arg Ala Gly Leu Tyr Pro Gly Pro Arg Glu Asp Tyr Ala Leu Pro
115 120 125
Ala Gly Leu Glu Val Ser Gly Lys Leu Arg Val Ala Leu Asn Asn His
130 135 140
Leu Leu Trp Ser Lys Phe Asn Gln His Gln Thr Glu Met Ile Ile Thr
145 150 155 160
Lys Gln Gly Arg Arg Met Phe Pro Phe Leu Ser Phe Thr Val Ala Gly
165 170 175
Leu Glu Pro Thr Ser His Tyr Arg Met Phe Val Asp Val Val Leu Val
180 185 190
Asp Gln His His Trp Arg Tyr Gln Ser Gly Lys Trp Val Gln Cys Gly
195 200 205
Lys Ala Glu Gly Ser Met Pro Gly Asn Arg Leu Tyr Val His Pro Asp
210 215 220
Ser Pro Asn Thr Gly Ala His Trp Met Arg Gln Glu Val Ser Phe Gly
225 230 235 240
Lys Leu Lys Leu Thr Asn Asn Lys Gly Ala Ser Asn Asn Val Thr Gln
245 250 255
Met Ile Val Leu Gln Ser Leu His Lys Tyr Gln Pro Arg Leu His Ile
260 265 270
Val Glu Val Asn Asp Gly Glu Pro Glu Ala Ala Cys Asn Ala Ser Asn
275 280 285
Thr His Ile Phe Thr Phe Gln Glu Thr Gln Phe Ile Ala Val Thr Ala
290 295 300
Tyr Gln Asn Ala Glu Ile Thr Gln Leu Lys Ile Asp Asn Asn Pro Phe
305 310 315 320
Ala Lys Gly Phe Arg Glu Asn Phe Glu Ser Met Tyr Thr Ser Val Asp
325 330 335
Thr Ser Ile Pro Ser Pro Pro Gly Pro Asn Cys Gln Phe Leu Gly Gly
340 345 350
Asp His Tyr Ser Pro Leu Leu Pro Asn Gln Tyr Pro Val Pro Ser Arg
355 360 365
Phe Tyr Pro Asp Leu Pro Gly Gln Ala Lys Asp Val Val Pro Gln Ala
370 375 380
Tyr Trp Leu Gly Ala Pro Arg Asp His Ser Tyr Glu Ala Glu Phe Arg
385 390 395 400
Ala Val Ser Met Lys Pro Ala Phe Leu Pro Ser Ala Pro Gly Pro Thr
405 410 415
Met Ser Tyr Tyr Arg Gly Gln Glu Val Leu Ala Pro Gly Ala Gly Trp
420 425 430
Pro Val Ala Pro Gln Tyr Pro Pro Lys Met Gly Pro Ala Ser Trp Phe
435 440 445
Arg Pro Met Arg Thr Leu Pro Met Glu Pro Gly Pro Gly Gly Ser Glu
450 455 460
Gly Arg Gly Pro Glu Asp Gln Gly Pro Pro Leu Val Trp Thr Glu Ile
465 470 475 480
Ala Pro Ile Arg Pro Glu Ser Ser Asp Ser Gly Leu Gly Glu Gly Asp
485 490 495
Ser Lys Arg Arg Arg Val Ser Pro Tyr Pro Ser Ser Gly Asp Ser Ser
500 505 510
Ser Pro Ala Gly Ala Pro Ser Pro Phe Asp Lys Glu Ala Glu Gly Gln
515 520 525
Phe Tyr Asn Tyr Phe Pro Asn
530 535
<210> 61
<211> 1211
<212> DNA
<213> Intelligent
<400> 61
acattgttct gatcatctga agatcagcta ttagaagaga aagatcagtt aagtcctttg 60
gacctgatca gcttgataca agaactactg atttcaactt ctttggctta attctctcgg 120
aaacgatgaa atatacaagt tatatcttgg cttttcagct ctgcatcgtt ttgggttctc 180
ttggctgtta ctgccaggac ccatatgtaa aagaagcaga aaaccttaag aaatatttta 240
atgcaggtca ttcagatgta gcggataatg gaactctttt cttaggcatt ttgaagaatt 300
ggaaagagga gagtgacaga aaaataatgc agagccaaat tgtctccttt tacttcaaac 360
tttttaaaaa ctttaaagat gaccagagca tccaaaagag tgtggagacc atcaaggaag 420
acatgaatgt caagtttttc aatagcaaca aaaagaaacg agatgacttc gaaaagctga 480
ctaattattc ggtaactgac ttgaatgtcc aacgcaaagc aatacatgaa ctcatccaag 540
tgatggctga actgtcgcca gcagctaaaa cagggaagcg aaaaaggagt cagatgctgt 600
ttcgaggtcg aagagcatcc cagtaatggt tgtcctgcct gcaatatttg aattttaaat 660
ctaaatctat ttattaatat ttaacattat ttatatgggg aatatatttt tagactcatc 720
aatcaaataa gtatttataa tagcaacttt tgtgtaatga aaatgaatat ctattaatat 780
atgtattatt tataattcct atatcctgtg actgtctcac ttaatccttt gttttctgac 840
taattaggca aggctatgtg attacaaggc tttatctcag gggccaacta ggcagccaac 900
ctaagcaaga tcccatgggt tgtgtgttta tttcacttga tgatacaatg aacacttata 960
agtgaagtga tactatccag ttactgccgg tttgaaaata tgcctgcaat ctgagccagt 1020
gctttaatgg catgtcagac agaacttgaa tgtgtcaggt gaccctgatg aaaacatagc 1080
atctcaggag atttcatgcc tggtgcttcc aaatattgtt gacaactgtg actgtaccca 1140
aatggaaagt aactcatttg ttaaaattat caatatctaa tatatatgaa taaagtgtaa 1200
gttcacaact a 1211
<210> 62
<211> 166
<212> PRT
<213> Intelligent
<400> 62
Met Lys Tyr Thr Ser Tyr Ile Leu Ala Phe Gln Leu Cys Ile Val Leu
1 5 10 15
Gly Ser Leu Gly Cys Tyr Cys Gln Asp Pro Tyr Val Lys Glu Ala Glu
20 25 30
Asn Leu Lys Lys Tyr Phe Asn Ala Gly His Ser Asp Val Ala Asp Asn
35 40 45
Gly Thr Leu Phe Leu Gly Ile Leu Lys Asn Trp Lys Glu Glu Ser Asp
50 55 60
Arg Lys Ile Met Gln Ser Gln Ile Val Ser Phe Tyr Phe Lys Leu Phe
65 70 75 80
Lys Asn Phe Lys Asp Asp Gln Ser Ile Gln Lys Ser Val Glu Thr Ile
85 90 95
Lys Glu Asp Met Asn Val Lys Phe Phe Asn Ser Asn Lys Lys Lys Arg
100 105 110
Asp Asp Phe Glu Lys Leu Thr Asn Tyr Ser Val Thr Asp Leu Asn Val
115 120 125
Gln Arg Lys Ala Ile His Glu Leu Ile Gln Val Met Ala Glu Leu Ser
130 135 140
Pro Ala Ala Lys Thr Gly Lys Arg Lys Arg Ser Gln Met Leu Phe Arg
145 150 155 160
Gly Arg Arg Ala Ser Gln
165
<210> 63
<211> 884
<212> DNA
<213> Intelligent
<400> 63
cagccacaat gaggaactcc tatagatttc tggcatcctc tctctcagtt gtcgtttctc 60
tcctgctaat tcctgaagat gtctgtgaaa aaattattgg aggaaatgaa gtaactcctc 120
attcaagacc ctacatggtc ctacttagtc ttgacagaaa aaccatctgt gctggggctt 180
tgattgcaaa agactgggtg ttgactgcag ctcactgtaa cttgaacaaa aggtcccagg 240
tcattcttgg ggctcactca ataaccaggg aagagccaac aaaacagata atgcttgtta 300
agaaagagtt tccctatcca tgctatgacc cagccacacg cgaaggtgac cttaaacttt 360
tacagctgac ggaaaaagca aaaattaaca aatatgtgac tatccttcat ctacctaaaa 420
agggggatga tgtgaaacca ggaaccatgt gccaagttgc agggtggggc aggactcaca 480
atagtgcatc ttggtccgat actctgagag aagtcaatat caccatcata gacagaaaag 540
tctgcaatga tcgaaatcac tataatttta accctgtgat tggaatgaat atggtttgtg 600
ctggaagcct ccgaggtgga agagactcgt gcaatggaga ttctggaagc cctttgttgt 660
gcgagggtgt tttccgaggg gtcacttcct ttggccttga aaataaatgc ggagaccctc 720
gtgggcctgg tgtctatatt cttctctcaa agaaacacct caactggata attatgacta 780
tcaagggagc agtttaaata accgtttcct ttcatttact gtggcttctt aatcttttca 840
caaataaaat caatttgcat gactgtaaaa aaaaaaaaaa aaaa 884
<210> 64
<211> 247
<212> PRT
<213> Intelligent
<400> 64
Met Gln Pro Ile Leu Leu Leu Leu Ala Phe Leu Leu Leu Pro Arg Ala
1 5 10 15
Asp Ala Gly Glu Ile Ile Gly Gly His Glu Ala Lys Pro His Ser Arg
20 25 30
Pro Tyr Met Ala Tyr Leu Met Ile Trp Asp Gln Lys Ser Leu Lys Arg
35 40 45
Cys Gly Gly Phe Leu Ile Arg Asp Asp Phe Val Leu Thr Ala Ala His
50 55 60
Cys Trp Gly Ser Ser Ile Asn Val Thr Leu Gly Ala His Asn Ile Lys
65 70 75 80
Glu Gln Glu Pro Thr Gln Gln Phe Ile Pro Val Lys Arg Pro Ile Pro
85 90 95
His Pro Ala Tyr Asn Pro Lys Asn Phe Ser Asn Asp Ile Met Leu Leu
100 105 110
Gln Leu Glu Arg Lys Ala Lys Arg Thr Arg Ala Val Gln Pro Leu Arg
115 120 125
Leu Pro Ser Asn Lys Ala Gln Val Lys Pro Gly Gln Thr Cys Ser Val
130 135 140
Ala Gly Trp Gly Gln Thr Ala Pro Leu Gly Lys His Ser His Thr Leu
145 150 155 160
Gln Glu Val Lys Met Thr Val Gln Glu Asp Arg Lys Cys Glu Ser Asp
165 170 175
Leu Arg His Tyr Tyr Asp Ser Thr Ile Glu Leu Cys Val Gly Asp Pro
180 185 190
Glu Ile Lys Lys Thr Ser Phe Lys Gly Asp Ser Gly Gly Pro Leu Val
195 200 205
Cys Asn Lys Val Ala Gln Gly Ile Val Ser Tyr Gly Arg Asn Asn Gly
210 215 220
Met Pro Pro Arg Ala Cys Thr Lys Val Ser Ser Phe Val His Trp Ile
225 230 235 240
Lys Lys Thr Met Lys Arg Tyr
245
<210> 65
<211> 3394
<212> DNA
<213> Intelligent
<400> 65
gtgcttgaga aggttcaatg gcgtggcagg gactagcggc cgagttcctg caggtgccgg 60
cggtgacgcg ggcttacacc gcagcctgtg tcctcaccac cgccgcggtg gtaagcggcc 120
gggcggaccg gacgtcgcct tggttacagc ctctggcggg aggggtgagg gtcgccatgg 180
ttacggcgtg gctcccgggc agctcttggc tggcccctgg ttccacagca gctggagctc 240
ctcagcccct ttcaactcta cttcaacccg caccttgtgt tccggaagtt ccaggtctgg 300
aggctcgtca ccaacttcct cttcttcggg cccctgggat tcagcttctt cttcaacatg 360
ctcttcgtgt tccgctactg ccgcatgctg gaagagggct ccttccgcgg ccgcacggcc 420
gacttcgtct tcatgtttct cttcgggggc gtccttatga ccgtatcctt cccgcaggct 480
ctggaacctc gggctagggc gcctcggcgt ccagcctgtg ttggtcctgg ggccaacaca 540
gccatgccag aaagggacac agtcgctgtc tccagcttag tatgtgttga gggcccactc 600
tgtgctcagc tgcaggggtc agggctagat cttcagtgct gtatgcaaaa tacaaagcca 660
cgcacaaaag agccaggcac cgttcctgcc ttgggcgctc atgggcttct cgctgctgct 720
gggcaactcc atcctcgtgg acctgctggg gattgcggtg ggccatatct actacttcct 780
ggaggacgtc ttccccaacc agcctggagg caagaggctc ctgcagaccc ctggcttcct 840
gtgagtgttg agagccctcc ctccctctcc ccaccctcag aaggatcccc accgatgggg 900
acctgtgctg gcctgtgctc aacacgggcc cctccccaca gaaagctgct cctggatgtc 960
cctgcagaag accccaatta cctgcccctc cctgaggaac agccaggacc ccatctgcca 1020
cccccgcagc agtgaccccc acccagggcc aggcctaaga ggcttctggc agcttccatc 1080
ctacccatga cccctacttg gggcagaaaa aacccatcct aaaggctggg cccatgcaag 1140
ggcccacctg aataaacaga atgagctgca gtctcttggc ccacagcact ggcttcccca 1200
tctcacctgg ccacatcctt ctatgcctgc cccgtcctca ctcagtgtgg cctctcagcc 1260
caactgcagg tggtaggata ggggtgccca cagagggcaa agaaactgcc catggttgcc 1320
tggcagagct ttgagctcac aggttgccag gcagagcttt tgagctcaca ggtgacaggc 1380
tcagggttct catcctggcc ccaccagggc cttgggcaag tcctgcccac cataggcctc 1440
tgctacctgc cagccagcgg ggaagttcac cagatttcgg ctgctggggc caggacaggc 1500
ctctcctagg ttgtgccaaa ccagcctaca gatgttcctg ccagtggtgc cttcaggctg 1560
atgccaatct agcctctcct gtctctcatc agccaccctg acaggtgggc gtatgcctca 1620
tttttcatct ggtgatgcca aagccccatg gattcaggtg cagaagaggg ccaggactag 1680
gtcttctgcc ctttctatga cctcagagcc taagttttca ccttagcaga gttctgagac 1740
tgggtgaggc agggacttct ggaaggttct gttcctgccc tttttagctg aggacgtgtg 1800
tgagccttat ccgacccctg tggctcattt ttctcttctg acctggcagc tttccttgtt 1860
gttctaagcc tgtccatgtt gtggtttatt tctggatgct cagtggcacg gggcctcctc 1920
caaagacagg ttgtcatttt catggtaaca acactgttct ctgttgagtc tgccctccgt 1980
gttgtagcca gaccttgtgg agatggcttt gcggcggtgt gagctggcgg tcaggagtac 2040
ccagccttcc cggcacctcc cagccaggtg gccctgcccg acctgtgggg tgaggcagcc 2100
aaggttcctt ccatcccccc agttgtggag acacagggct gcctcaccct ttcattgccg 2160
aggttcctac ctcatggaca gaacaaacac ctcagcaatg aaacctgttc atgtctaaga 2220
gcagctgggc tgggaatctt cccctttgtt caaggccttc cagtaaggcc cagctgtccc 2280
cttgctgtgc atggggctct ggggagttcc actctttgat ggagggcaga ggccctgagt 2340
gcaaactccc tgggaagagt cccatgctaa catgtgctca aaggagcccc cctctcacat 2400
ctcagcgacc aagaacccca atccctaatc agagctctgc ctctgcccca tatggggccc 2460
taccccactt ccagggagca cagcagcctc tgaccctagc cctgccctgg cagcatggga 2520
cctgccaaca gctgagggtg gcagcagtct gtgctgggat ctgtgcccgg atctgtgccc 2580
attctcttca gtaaggctgg agctgcgagc cagtttgctg ccctcccaga tcctgtgtcc 2640
attctgaaga atggggacac ctccctatta cagatgagaa cagaggggac atgaactcct 2700
tggaggcagg gctgggaagg gaccctgggc tgtgtctcct ccctgtaccg tgtcaactcc 2760
aagagctggc accaggccgg gagggctatt cccatattcc tcacagctgg cttgtaaggc 2820
aggagctggc ccaggccaca gcacctgctg gggtgggaaa gggccccagc tgacctggct 2880
atgggtgcca ctggagctag aacagccctc ctgcacccag gctggcgaca gcccagcagt 2940
gcccacacag gactgggccc tccgcagggg acttcagagc agcaaggccc cagctggcag 3000
tagcctgacc atctggacac agcagagcca gggcggccca gggacggcag gagagctcgc 3060
ggcaccttcc tgaggccaag caaggggagc agggttaggg ctgttcctga aaggcagaga 3120
gcctctgccc tgagcctcac agctactctt ctcagctctc tgggtctgga aggagaacag 3180
gctgagggga gctgagagga gctgaggtgc tacccggagc cccattcacc cccacctgcc 3240
cacttgggaa tctgaggcag aggagggtga ggcctgtgtg ccaaccttgt tcacatacca 3300
ccttcgtccc cccaggcccc ggccccactc ctggctctca ttatttttat gttaaaactt 3360
tgaagaaatt gaacatgacc tgttgaagaa attg 3394
<210> 66
<211> 235
<212> PRT
<213> Intelligent
<400> 66
Met Ala Trp Gln Gly Leu Ala Ala Glu Phe Leu Gln Val Pro Ala Val
1 5 10 15
Thr Arg Ala Tyr Thr Ala Ala Cys Val Leu Thr Thr Ala Ala Val Gln
20 25 30
Leu Glu Leu Leu Ser Pro Phe Gln Leu Tyr Phe Asn Pro His Leu Val
35 40 45
Phe Arg Lys Phe Gln Val Trp Arg Leu Val Thr Asn Phe Leu Phe Phe
50 55 60
Gly Pro Leu Gly Phe Ser Phe Phe Phe Asn Met Leu Phe Val Phe Arg
65 70 75 80
Tyr Cys Arg Met Leu Glu Glu Gly Ser Phe Arg Gly Arg Thr Ala Asp
85 90 95
Phe Val Phe Met Phe Leu Phe Gly Gly Val Leu Met Thr Leu Leu Gly
100 105 110
Leu Leu Gly Ser Leu Phe Phe Leu Gly Gln Ala Leu Met Ala Met Leu
115 120 125
Val Tyr Val Trp Ser Arg Arg Ser Pro Arg Val Arg Val Asn Phe Phe
130 135 140
Gly Leu Leu Thr Phe Gln Ala Pro Phe Leu Pro Trp Ala Leu Met Gly
145 150 155 160
Phe Ser Leu Leu Leu Gly Asn Ser Ile Leu Val Asp Leu Leu Gly Ile
165 170 175
Ala Val Gly His Ile Tyr Tyr Phe Leu Glu Asp Val Phe Pro Asn Gln
180 185 190
Pro Gly Gly Lys Arg Leu Leu Gln Thr Pro Gly Phe Leu Lys Leu Leu
195 200 205
Leu Asp Ala Pro Ala Glu Asp Pro Asn Tyr Leu Pro Leu Pro Glu Glu
210 215 220
Gln Pro Gly Pro His Leu Pro Pro Pro Gln Gln
225 230 235
<210> 67
<211> 1173
<212> DNA
<213> Intelligent
<400> 67
ggcggcctgg cccgggacct gctgctgctc cagccatgtc catgacaacc agagcctggg 60
aggagctgga tggcggcctg ggcagctgcc aggccctgga ggaccactct gcgctggccg 120
agacccagga ggacagggct tcagcgacac ccaggctggc cgactccggc agcgtgcccc 180
acgactctca ggtggctgaa ggccccagtg tggacaccag gcccaagaag atggaaaaag 240
agcctgccgc cagggggacc ccaggaacgg ggaaggagag gctgaaagcc ggagcgagcc 300
ctcggagcgt ccccgcgcgc aagaaggcgc agaccgcgcc gcccctgcag ccgccgccgc 360
cgcccccggc cctgagcgag gagctgccct ggggagacct gtcgctcaac aagtgcctgg 420
tgctcgcctc gctggtggcg ctgctgggct cggctttcca gctgtgccgc gacgccgtcc 480
ctggggaggc agcactccaa gcacgtgtgc ccgagccctg ggtcccgcca agctcagccc 540
cgagggagcc atcgtcgccc ctgcctaagt tcgaggccca ggcgcctcca tcagcgccgc 600
ctgcgccccg ggccgaggca gaggtcagac ccaagattcc cgggagtcgg gaggctgcag 660
agaacgacga agaggagccc ggcgaggcca ccggagaggc cgtccgggag gaccgtgtga 720
ccctcgcaga ccggggaccc aaggagaggc ctcggagaga ggggaagccg cggaaggaga 780
agccgcggaa ggaggagaga cctaagaaag agaggccgcg gaaagaggag aggccacggg 840
ccgccaggga gccccgggaa gccctacccc agcgctggga gtcacgcgaa gggggccacc 900
ggccgtgggc acgggactcc agggacgccg agcccaggaa gaagcaggcc tgggtgtccc 960
cgaggcgtcc cgacgaggag cagcggcctg ggagtcgcca gaagctccgc gcaggcaagg 1020
ggcgggactg agccggcccc gcgccggagt ccaggggccc cttctggacg ccccgcgact 1080
ctggcgaaat aaagcgagtg ctgcggcaaa aaaaaaaaaa aaaaaaaaaa aaaaaaaaaa 1140
aaaaaaaaaa aaaaaaaaaa aaaaaaaaaa aaa 1173
<210> 68
<211> 331
<212> PRT
<213> Intelligent
<400> 68
Met Ser Met Thr Thr Arg Ala Trp Glu Glu Leu Asp Gly Gly Leu Gly
1 5 10 15
Ser Cys Gln Ala Leu Glu Asp His Ser Ala Leu Ala Glu Thr Gln Glu
20 25 30
Asp Arg Ala Ser Ala Thr Pro Arg Leu Ala Asp Ser Gly Ser Val Pro
35 40 45
His Asp Ser Gln Val Ala Glu Gly Pro Ser Val Asp Thr Arg Pro Lys
50 55 60
Lys Met Glu Lys Glu Pro Ala Ala Arg Gly Thr Pro Gly Thr Gly Lys
65 70 75 80
Glu Arg Leu Lys Ala Gly Ala Ser Pro Arg Ser Val Pro Ala Arg Lys
85 90 95
Lys Ala Gln Thr Ala Pro Pro Leu Gln Pro Pro Pro Pro Pro Pro Ala
100 105 110
Leu Ser Glu Glu Leu Pro Trp Gly Asp Leu Ser Leu Asn Lys Cys Leu
115 120 125
Val Leu Ala Ser Leu Val Ala Leu Leu Gly Ser Ala Phe Gln Leu Cys
130 135 140
Arg Asp Ala Val Pro Gly Glu Ala Ala Leu Gln Ala Arg Val Pro Glu
145 150 155 160
Pro Trp Val Pro Pro Ser Ser Ala Pro Arg Glu Pro Ser Ser Pro Leu
165 170 175
Pro Lys Phe Glu Ala Gln Ala Pro Pro Ser Ala Pro Pro Ala Pro Arg
180 185 190
Ala Glu Ala Glu Val Arg Pro Lys Ile Pro Gly Ser Arg Glu Ala Ala
195 200 205
Glu Asn Asp Glu Glu Glu Pro Gly Glu Ala Thr Gly Glu Ala Val Arg
210 215 220
Glu Asp Arg Val Thr Leu Ala Asp Arg Gly Pro Lys Glu Arg Pro Arg
225 230 235 240
Arg Glu Gly Lys Pro Arg Lys Glu Lys Pro Arg Lys Glu Glu Arg Pro
245 250 255
Lys Lys Glu Arg Pro Arg Lys Glu Glu Arg Pro Arg Ala Ala Arg Glu
260 265 270
Pro Arg Glu Ala Leu Pro Gln Arg Trp Glu Ser Arg Glu Gly Gly His
275 280 285
Arg Pro Trp Ala Arg Asp Ser Arg Asp Ala Glu Pro Arg Lys Lys Gln
290 295 300
Ala Trp Val Ser Pro Arg Arg Pro Asp Glu Glu Gln Arg Pro Gly Ser
305 310 315 320
Arg Gln Lys Leu Arg Ala Gly Lys Gly Arg Asp
325 330
<210> 69
<211> 32230
<212> DNA
<213> Intelligent
<400> 69
gaattcactc atcaccaagg ggaagatgct caatcattca tgagggatct gcccccttga 60
tctaatcacc tcctagtggc cccacttcca acactgggaa tcatattaca acatgagatt 120
tggaggggac aaatatataa accatatcct tccacccctg gtcccccaaa tctcatgtcc 180
ttctcatgtt gcaaaataca atcatgcctt ctcaacagtc ccccaaagtc ttacctcatt 240
ccagaatcaa caaaaaattc ccaagtccca agtctcatct gaagatgagt cccttccacc 300
tatcagccta ggaaatcaaa gacaaattga ctcccaaaat acaatgagag tgcagacatt 360
gggtaaacat tcccattcca caagggagaa gttggcaaaa agaaaggatc tacatgcccc 420
atacacgtca gaaatccagc agggcagtta ttaaatctta aagctccaag gtaatctcct 480
ttgacttcat gtcccatatc cagggcacac tggtgcaggg ggtgggctcc caaagccttg 540
gacaactcta cccctgtggc tttggaggat gtcgcccctg tggcttctct cacacgatag 600
agttgagtgc ctgtggcttt tccagattca gggtgcaaac tgccagtgga tctaccattc 660
tggggtctgg aggacagtgg cccccttccc acagctccac taggcagtgc cctggtgggg 720
acattatatg ggggttcaac cccacattct ctttggcact gctctagtag aggttctctg 780
tgagggctcc atgctggcag gaggcttctc tctgggcacc tagggtttct catacatttc 840
tgaaatctag agtgaagatg ccaagcctcc ttcactcttg cattctgggg gcctacaggc 900
ttaacaccag atggaagttc ccaaggctta tagtggcttg cactctccaa agaagcagcc 960
taagctgtac ttggggccct ttgagccaag gctggagcca gaggaaccag gatgtggaga 1020
gcagtgtccc aaggctgcac aggcagcagt ggccatgggc atggcccaca aaaccatcct 1080
ttccctcttg gcctctgggc ctgttatggg aaagaccacc tcagagattt ccgaaaggcc 1140
ttcaaggcct ttttcccttt gttctggata tgagcactta gctccctttt agttatgcta 1200
atctctctag caactggctg ctccatagcc tacttatatt tgtctcctga aaataccttt 1260
tcttttctac cacatggcca ggctgtgaat tttccacatt ttttatgctc tgcttccctt 1320
tgttgatgaa aaaagccaaa ctccataaaa cacttgacga gattgattct gagccacatg 1380
tgagagccat gaactgtggc acagcctcaa aaggtcctga gaacacctgt gcaaggtggt 1440
tgggttgcgg cctgctttta tgttttaggg agacatatca atcaatacat gtaaagtata 1500
cattggtttg gtttggtttg gaaaagcagg acaattcaaa gtggggaatt ccaaatcata 1560
ggtggatttg aagattttct gattggcaat tggctgaaaa agttaaatta tctaaaaagt 1620
tgaagtcagc aaaaagcaat gcttaagata agggggttgt ggaagccaag tttcttgtta 1680
tgtagatgaa gcctccacgt tccagagaga agagatggtc aatgtctctt atcagaacct 1740
aaaaggtgcc agactcttgg ataaatctct cctgaatcag gaagagacct ggaaagggaa 1800
aaagattctc aacagaatat acatttcctc cacaagagac ggctttgcag ggcccttcca 1860
aaatgtgtca gagaaatata ttctggcata aaatacttta atttccttcc atgcctgcca 1920
cctgtcatgt gatgctatac cagaatcagg ttgggatttg atatcttatt gctacaaaga 1980
gtctgctttg tcagtcttaa gctccctgtt ttaatgttaa cactggtcag ctgagcctaa 2040
gctccaacag ggagagggta tagtgaggga gtccaaacca ccctcccctt cctgtcatgg 2100
cctgaactgg ttttccaggt ttctttggaa tccccttgga ttagcatttt attttgtcgt 2160
ttacaccttt taaatataag ttccaacttt aagtcatttc tttgctccca tatcttacca 2220
tagactgtta gaagcaacca ggtcacacct tagaaacatc tgcttagaaa tgtcttccac 2280
agatgcccta agtcatcact cttaaggtca accttccaca gatccctagg gcatgaacac 2340
aatgcagcca agttgtttct taggatttaa caagcgtgac ctttacacca gttcccaata 2400
agtttctcat ttccatctga gatttcatca gcctggcttt cacagtccat atgtctatca 2460
gcattttggt gacaaccatt taatagtctc taagaaattc caaactttcc ctcatcttcc 2520
tgtcttcttc tgagtcctcc aaattcttct aacctctctg cctgttacct gattccaaag 2580
ctgcttccac attttcaggt atccttatag caatgttcca ctcctcaata ccaatgttct 2640
gagttagtct atttgtgtta ctagaaaaaa aaaaaaaaca tgaatctggt aatttataaa 2700
gaaaagaggt ttgcaccagg cactgtggca aggaagggag gattaactag ctcacagttc 2760
tgcagccatt ccggaaacac ggccctggca tctgcttctg gcgaggcctc agggagattg 2820
caatcacggc agaaggcgaa gggggagcag gcatgtcaca tggcaagagg gagcaagaga 2880
agagaagtgg cacgtcctag acttttaaac aaccagctgt cacagggact aactgaggga 2940
gaactcactc atcacctggg agatggtgct aggccattca tgaggggtcc agccccatga 3000
tctaatcacc tcccaccagg cccacctcca acactgggaa tcacatctca acatgaaatt 3060
tggagagaca cacatccaaa ctattgcacc acaggaagct ggaagaggtg gacggtcctc 3120
ccctggagca ctcagagaca gccaccaaca ccttgatctc agattcctga ctcccagaac 3180
tctgaaaaaa tttttgttgt tttaagccac atttgtgata ttttgttacg gcagccacag 3240
cacggatata gctggtaaca gagttcttta gcctccaaaa tacaagcctg gggtaaataa 3300
ctattgaatt tggccacatg gaaatcagga agaatgtaat aagcatcatc gatggacggg 3360
atgacctggg agatcgtggc aagtttaaag ctaattggaa gttggcaacc aaaaaatcct 3420
gtcttgcaaa ttgccaggaa attgccaaga aaacttttag aaaacatggt taaagatgga 3480
gaaacctgga tgaatccctg gtttctgaag aggtgcttag gcattgaagt gagactgatg 3540
agacttcaca ctgtaccttc agaagggcag acactcacga gatcatcaac cacggctccc 3600
tcgctgggag gcagacacag agctggaggc ggcggccaca aactaggtgg gcagagaggc 3660
gtcagcatcg ggacttgcgg gaggccctgg gaaggaacag gcagcggtgg ggcctggaca 3720
gccctgggga aaggaagtta cttggaggag accaggggct tgcatttggg ccaaaaccaa 3780
ggacaagaga tcagctggtc ccagggaact ctggagccca gcaccccacc acgggtgcag 3840
ggtcctgaca acccgagagg gctgtgggca ccgggcacca gcctgtgggg attctgaagg 3900
ctgctgccca gccacacgtc ccggttctga acaaagggtt caagagacac ctgcaaacct 3960
acctttctga gagcagcctc ttagcctcag ctggtattgg cctttggtca ccccacatgc 4020
cccgacagtg gggcctggcc tcagaaaggg gcccctccat ttgtactttc tatctgatcc 4080
ttgacacagt gctaacacca aagaccaaac ccgaatcttg gttcacatac tctgcaaaga 4140
aatgactaag actagttctt ccggaggtca gttttagaac gtttattctg acttaattct 4200
gccttatctc tgtgcaccaa gaaaactatc tgcacatctg tagtaaaatg tgaaggtacc 4260
ttcattttgt ttgtatacta aacttttaag aaatacctca ctttttaaaa cttggttttg 4320
tgttttgtat gcttataata ttttccataa tagatcattt taatgatgaa ctctgagtct 4380
tctgacagaa tgcagatcaa tggattccta gccatcaggg aggcgttgat tgcaaagggg 4440
cctggtggaa tttttggaga gattctacat cttcttgcaa ctgttcatct ggattacggt 4500
ggtggttgca tgactgtgca tttgttgaaa cttacatgtc acaggatgga ttatactgaa 4560
tgtaaactac acttgagtaa atatgacttt taaaacttta aaaagttggg ggatggttca 4620
ctgccccggc tcgaagcccc ctggccacgc tgcctggcca gcccaccccc atccctgcca 4680
gcgcttgcct ccagcgtccc aacagcctcc tgaccccctg ggctgctcta aaccctcagg 4740
agcgcagcca tccgggatca gctggatgga gatggggagc ccgagactcg tgccacacca 4800
cgtcctcccg cccacaccag ccacacgcag acgtcaaagc agcactgtcc tcgcacgcac 4860
tgctcccacc caccctggca cggccattcc aggcctgggg caggaaggca gatgctcccc 4920
ctgcccccag acacaagcat tcctgcacac acccccagca cacacacgca ctcccatgcg 4980
cacactgaca cacacaggtg tgtgcagctg agacacagcc cgttcccagg aagcccagcc 5040
cccatcactg agggaaaggg gcagcaccgt agggccacag gagtggcagc tggacacaga 5100
gccaggagct ggtgaaggcc caggccactg aggcgggctg ccggcatggc tgggcgtgaa 5160
ggccagaaga gggcaggagg ggctgggggc actatgccta ttgggcctag gtgggcacac 5220
gccgggcagg agaggaacag cccagcccct cagacaggaa ggggtggggg caggggccat 5280
ttgtggaggc cagggcaggg ccagcacccc aaggaaaagc agagcagggt gagaacggac 5340
atggggctca gagctgagca ggcctgctgg gccccaggag ggagacacag atgaccggag 5400
atctcaaggc tggcagaggc cagagatgga gccccagctg ggaagccatc ctccttcctg 5460
ggggcccacg ctgcccggcc cctccagccc agcaagcttg gggcattgga tagaaccggg 5520
agagagccga ccaggcactg aggcccctgc cccaaatgcc cacagcctgg ggaaaatgag 5580
caggtacatg ggaggggcaa gtggagcccc aggcacaccc acacagtgca cacggcctca 5640
cctgggccgg agggggcagg aggctcgcca ccccgctgtg gtttctctcc taatctcacc 5700
ctgggtttct ctcacacttg atgcagatga tgtttctctg acattgtgga ctaagagttg 5760
gtgctggaag gggttagcca tcttggagat gttgctatgg gatgcaggga ttttgcgtgt 5820
gagaaggaca tgattatggg gggaacggag ggcaaactgt catgggttaa aatgtgtccc 5880
ctataaattc atgtgttgaa gtcctaaccc ccaggaccgc agaatgtgac cttgtctgga 5940
aacagtcttt gcagctgcaa tcaagttcag atgaggtcac cctggagtag ggcaagcctc 6000
tgatccaata tgactgctgt cctcatgaaa agggggaatc tgggcacaga cagcacgtgg 6060
ggagaacgcc ctgtgaagat ggtgctgctt ccataagcca agagcaccag agacggccgg 6120
caaagcccag cagcaaggag agagcctggg acagagtctc ccatgacaca gaggagccag 6180
ccccaccgag gcctccatcc cagatgcccg gcctccagaa ccaggacgga ataaacgtct 6240
gttgtttaag ccacgcagtc tggggtgcag tgttgccagg gccacagtta acggatacga 6300
gtgttgtcct gagctgccag ccccacaggc tgcacgaggc ctccctgccc cagcccagtg 6360
cagactcccc agccccctgg gtgtgccatg ggcagtgggg ggcccctcac tccgtcctcc 6420
cccagcctgg gaggttgagc ccattatgag ctccatgggg tgaagctgga acgagaggct 6480
gggagccgac tgggagcctg cggctggagg atggatttcc ccagggaccc acacgtgcac 6540
ctccacctgt ctcctggaca ttctctctga gggcagggct ggtgccagct cagggatcca 6600
gcagggtcac aagggcaggc cgggtccttg tggagagcac atttagtggg agggacatga 6660
tttcccttca aagtgcccat tctggacgct tcccgttcca tgctggacgc ttcctcttcc 6720
acgctggatg cttcctgttc cacgctggat gcttcctgtt ccacgctgga tgtttcctgt 6780
tacactctgg atgcttcctg ttccacactg gatgcttcct gttccatcct ggatgcttcc 6840
tgttccatgc tggacatttc ctgttccact ctggatgctc cctgttccat gctggatgct 6900
tcctgttcca tgctggatgc ttcctgttcc atgctggaca tttcctgttc cactctgcat 6960
gcttcctgtt ccactctgga tgcttcctgt tccacactgg acgcttcctg ctccacgctg 7020
gacgcttcct gttccatgct ggatgcttcc cgttacattc tggatgcttc ccgttccatg 7080
ctggacgctt cctgttccac gctggacgtt tcttgttcca ctctggatgc ttcctgttcc 7140
acgctggatg cttccttttc cacgctggac acttcctgtt ccgcgctgga cacttcctgc 7200
tccacactgg acgcttcctg ctccaggctg gacgcttcct gttccatgct ggatgcttcc 7260
tgttacattc tggatgcttc ccgttccatg ctggacgctt cctgttccac gctggacgtt 7320
tcttgttcca ctctggatgc ttcctgttcc acgctggacg cttcccattc cactctggat 7380
gcttcctgtt ccatgctgga catttcttgt tccactctgg atgcttcctg ttccatgctg 7440
gatgcttcct gttccatgct ggatgcttcc tgttccatgc tggacgtttc ttgttccact 7500
ctggatgctt cctgttacat gctggatgct tcctgttcca tgctggacgt ttcttgttcc 7560
actctggatg cttcctgttc catgctggat gcttcctgtt acattctgga tgcttcctgt 7620
tccatgctgg acatttcctg ttccactctg gatgcttcct gttacattct tgatgcttcc 7680
tgttccatgc tggacatttc ctgttccact ctggatgctt cctgttacat tctggatgct 7740
tcctgttcca tgctggacat ttcctgttcc actctggatg cttcctgtta cattctggat 7800
gcttcctgtt ccatgctgga catttcctgt tccactctgg atgcttcctg ttacattctt 7860
gatgcttcct gttccatgct ggacatttcc tgttccactc tggatgcttc ctgttacatt 7920
ctggatgctt cctgttccac tctggacgct tcccattcca ctctggatgc ttccttttcc 7980
atgctggacc tttcttgttc cactctggat gcttcctgtt ccatgctgga tgcttccttt 8040
tccattccgg acacttccta ttccattctg gacacttcct gtgcgacacc tcctcgggct 8100
tttggtctgc ccagtccctc tggcctcata ccatcccccc ttacctccca cttccacgtt 8160
cgtccttcct cagctcctcc ctctctctag agcttcggcc tggcaaggtc cctcctgatc 8220
tcagtccagg ctcccccagc acaggtagga gacttgcacc tgcccttgga cctccccacc 8280
ctgcatgatg ccagcatccc ccaggcccca gggaggcccc atttctctct ctgcttgtag 8340
tccagtggcc ctggagtgcc actgcaactc gggtgtgccc ctcgcctctg aggaagctaa 8400
gtgccctaag ctaagcagag gccatcccct ctgctcagcc ccagggccct gccccctacc 8460
ccttcccctc acctgcacca caggctctgg ccaactctgc ccaggctctg aatgggcccc 8520
tctggctccc ctctgctgct acactgccct gcaccacctc cactcagctt cagtgtgttc 8580
atccacctgt cccacgtccc ctcggccccc aggagcacag ctggtggccc tggctcctgg 8640
cagcccatct tgttccttct ggagcaccag cctcagaagc cttcctgtgc agggtccact 8700
cggccagccc tgggaccctc ctggtctcaa gcacacacat tctccctgca gccagacctg 8760
cccctgcctg tgagctcaga cctgagcctt ggaacgcctt cccttctcca tcccagctcg 8820
cctttgccag ctgctcagcg ggatgaactc acactcccct ccctgcacca tgagtgagag 8880
ccagctggag agacgcccag gccaaagcag ccaccagggc ccagtggggg tcagaagctt 8940
caggtgagag gcccaggtat tgagaggctg agaccacggg cagaatggtc ataatcactg 9000
ccagtatcag tccagcccca gggactcaga gacagagaaa agagcagtga acaaggtccg 9060
ggctccccac cttctcccac gagtatgggg gcagccacca cccccatccc cacacaccca 9120
tgaggcagcc tcggctgtgt ctggactccc ccttaccctg tgacacagaa accaccagaa 9180
gaaaagggaa cttcaggaag taagcggtgc cgccggtttc aatcctgttc ttagtctttg 9240
cagcgtggag ttcacacccc tggggacctg agggccgagc tgtgatttcc taggaagaca 9300
aatagcagct gacggcgtgg gcaagtctgc ccacatgtac cgcgccaaaa caggaagggc 9360
tgagaccccc acctcggtga gtagggtcag cacagggcaa gggcacaggc tcgggaggag 9420
aaggacagag cctgggtgca gccgtgggcg ctcctggacc tcagctgctg aacaggctac 9480
aagaggctgg ggagacgtgg gggcaaggcc agccccacat ggagacccaa gcggagccag 9540
cacgggggag gtgggcagcc ttcaggcacc aacgcccacc cagtgcaaga tgacggggac 9600
cgtgggcagg ggcttccaag ccaacagggc aggacacacc agaggctgac tgaggcctcc 9660
atgacgacca ggctgggagc acgaggaacc tgacgggatg cggcagagcc ggccgtgggg 9720
tgatgccagc atgggcagga cccacctgag ctgaggaggc agtagaacga gggaggagga 9780
gaggccccag gtgaacggag gggcttgtcc aggccagcag catcactgga gcccagggca 9840
gggtcagcag tgctggccgt ggggccctct ctcagccagg accaaggaca gcaggtgagc 9900
cgggagcaga gcagggaggg tgagtgtggc agcaggacag gagggtggaa gccaaggagc 9960
ccagaggcag aggcagggac aggggaggca caggggctag gctcagagcc acctgatggc 10020
gctggggcac ctgctggcgg ggagcagggc tgtggtcagc agcggagtgg aggggagagc 10080
tgtgctgagt gcacagatgg gaggagggaa gagtccaggg aggcccagaa aggcccagag 10140
tgcagcaggc ctggggcgag gggaggggtg aggctccgtg cgttcaggga gctgacccag 10200
cagagcagag gccactgagg agctgaggtt ctggagaggc ttccagagca ggagcagtgc 10260
agggacggga ggatctggga gctcacccag gaggggcaca tgggcaaggg caaggggctc 10320
tgttggggag acctgactgg acactggggc tgctccacag catagggaac aagccaagtg 10380
ctgcaaaaac aaaaatgagg ccagaaaaac agcccaaacc tggacagagg gtgccaggac 10440
aggcaggggg gcaacagtga cctgagtgac attgctgccc gggttgaggg agggcagagt 10500
gagcaggggg caggcattgg agttcagggt accaggaccg agcagccaca ggtgagcagg 10560
gcaggtgggg gcagaaggag cagggggcac ctcctggagc tcagcagacc agggcagagc 10620
aactgaaggt gaacaagggc aggtgggagg caggatgagc agggggaaga ccctggagct 10680
caggggacca gggcagagca gcctcaggtg cctcaggtga gcaggggctg gtgggtggca 10740
ggacgagtag gggacagctc ctggagctca ggggaccagg acagagcatc aagagctgag 10800
catggctagt gggaggtggg cgaacagggt gcagcccctg gaactcggga ccagggcaga 10860
gcagcggcag gtgagcacgg gctggtggga ggcaggagga acagggggca gctctgggac 10920
ttcaggggac caggggaggg catctgaagg tgaacagggg ctggtggggg caggaagagc 10980
agggggaagc ccctggagct caggggacca gggcagagca gccacaggtg agcaggggct 11040
ggtaggaagc aggaggagca ggggacagcc cctggagctc agagcaccag ggcagagcac 11100
cctcaggtaa gcaggggcag gtaggaggca ggacgagcag gggacagccc ctggagctca 11160
ggggacagag gagagcatca gaaggtgagc aggactgagg cttagcctca gggaatcaga 11220
gcagagcagc cacaggtgag cagggccggt gggaggcagg acgagcaggg gacaggcact 11280
agagctcagg gcaaggcaac cacaggtgag cagggccggt gggaggcatc actcagctcc 11340
tagattttgg caggagctgg gtagttgctg gcagcagaca gctgagggct ggtgaaagtg 11400
cagtgcagcc tcctggtgcc aggaagggag tgtgagccca tcccactgag cagttggcaa 11460
gggtgagctg ggatggagaa gggaaggcat tccagggctc ggggctgagc tctcaggcag 11520
gggcaggtgt ggctgcaggg ggaatgtgtg cttgagacca ggagggtccc agggctggcc 11580
ccagcggacc ctaggcagga aggcctctga ggctggcgcc ccagaaggag caagatgggc 11640
tgccaggagc cagggccacc agcacaatga agctgagtgg aggtggtgca gggcagtgta 11700
gcagcagagg gctgccagag gggcccattc agggcctggg cagagtcagc cagagcctgt 11760
ggtgcaggtg aggggaaggg gtggtgagcg gggccctggg gctgagcaga ggggatggcc 11820
tggctgaggg cagggcactt agcctcctca gaggtcaggg gcacacccca cctgcagtgg 11880
gactccaggg ccactgggcc agcggcagag agaaatgggg cctccctgtg gcctgggggt 11940
cctggcacca cgcagggtgg ggagggccaa gggcaggtgc aaggctccta cctgtgctgg 12000
ggggcctggg ttgagcccag cagggacctt gccgggggaa gctctggaga gagggaggag 12060
gtgggctggt ggccgagaag gccaggccag ggctgggagg gtgaggttgt ggtgactgag 12120
cctccagaag taatgcagga cactgggagg cagggggcat ccaggcactc agggccctga 12180
cctgggctgc tgcacactgg ggctaagggg aaaggagggg agaggctgag gaggaggctc 12240
caggaggcta ttccaaggca gggggttccg gggccctggg gctgaagggc gccgacccta 12300
tgcagtgtct ggcccctctg ctgcacagaa gaaaagggcc ttggagggca gagggcaggc 12360
tatgaccagg gccctgggca agtcaggccc actcactagc ggagggccac gctggggcgg 12420
cagggtcagg agcttcaggg gactcggggg acccacgaga agccatctga gaacagtgtc 12480
cactggtcaa gccaggcacc cataaaaggc tggagtgggg ccaatgggca tgagccgtcc 12540
ctgaggtggc accgatggcc agagctgagg ccaagctaga ggccctggac tgtgctgact 12600
cccggcaggc acagagcgct gacctggctg ccgagccccg cctcctaggc tgcaggggtg 12660
cctgcagaag ggcaccacag ggccaccggt cctgcaagct ttctggggca ggccgggcct 12720
gactttggct ttggggcagg gagggggcta aggtgacgca ggtggcgcca gccaggtgca 12780
cacccaatgc ccgtgagccc agacactgga ccctgcctgg accctcgcag atagacaaga 12840
accgaggggc ctctgcgccc tgggcccagc tctgtcccac accgcggtca catggcacca 12900
cctctcttgc agcctccacc aagggcccat cggtcttccc cctggcgccc tgctccagga 12960
gcacctccga gagcacagcg gccctgggct gcctggtcaa ggactacttc cccgaaccgg 13020
tgacggtgtc gtggaactca ggcgctctga ccagcggcgt gcacaccttc ccggctgtcc 13080
tacagtcctc aggactctac tccctcagca gcgtggtgac cgtgccctcc agcaacttcg 13140
gcacccagac ctacacctgc aacgtagatc acaagcccag caacaccaag gtggacaaga 13200
cagttggtga gaggccagct cagggaggga gggtgtctgc tggaagccag gctcagccct 13260
cctgcctgga cgcaccccgg ctgtgcagcc ccagcccagg gcagcaaggc aggccccatc 13320
tgtctcctca cccggaggcc tctgcccgcc ccactcatgc tcagggagag ggtcttctgg 13380
ctttttccac caggctccag gcaggcacag gctgggtgcc cctaccccag gcccttcaca 13440
cacaggggca ggtgcttggc tcagacctgc caaaagccat atccgggagg accctgcccc 13500
tgacctaagc cgaccccaaa ggccaaactg tccactccct cagctcggac accttctctc 13560
ctcccagatc cgagtaactc ccaatcttct ctctgcagag cgcaaatgtt gtgtcgagtg 13620
cccaccgtgc ccaggtaagc cagcccaggc ctcgccctcc agctcaaggc gggacaggtg 13680
ccctagagta gcctgcatcc agggacagac cccagctggg tgctgacacg tccacctcca 13740
tctcttcctc agcaccacct gtggcaggac cgtcagtctt cctcttcccc ccaaaaccca 13800
aggacaccct catgatctcc cggacccctg aggtcacgtg cgtggtggtg gacgtgagcc 13860
acgaagaccc cgaggtccag ttcaactggt acgtggacgg cgtggaggtg cataatgcca 13920
agacaaagcc acgggaggag cagttcaaca gcacgttccg tgtggtcagc gtcctcaccg 13980
tcgtgcacca ggactggctg aacggcaagg agtacaagtg caaggtctcc aacaaaggcc 14040
tcccagcccc catcgagaaa accatctcca aaaccaaagg tgggacccgc ggggtatgag 14100
ggccacatgg acagaggccg gctcggccca ccctctgccc tgggagtgac cgctgtgcca 14160
acctctgtcc ctacagggca gccccgagaa ccacaggtgt acaccctgcc cccatcccgg 14220
gaggagatga ccaagaacca ggtcagcctg acctgcctgg tcaaaggctt ctaccccagc 14280
gacatctccg tggagtggga gagcaatggg cagccggaga acaactacaa gaccacacct 14340
cccatgctgg actccgacgg ctccttcttc ctctacagca agctcaccgt ggacaagagc 14400
aggtggcagc aggggaacgt cttctcatgc tccgtgatgc atgaggctct gcacaaccac 14460
tacacacaga agagcctctc cctgtctccg ggtaaatgag tgccacggcc ggcaagcccc 14520
cgctccccag gctctcgggg tcgcgcgagg atgcttggca cgtaccccgt ctacatactt 14580
cccgggcacc cagcatggaa ataaagcacc cagcgctgcc ctgggcccct gcgagactgt 14640
gatggttctt tccgtgggtc aggccgagtc tgaggcctga gtggcatgag ggaggcagag 14700
cgggttccac tgtccccaca ctggcccagg ctgtgcaggt gtgcctgggc cgcctagggt 14760
ggggctcagc caggggctgc cctcggcagg gtgggggatt tgccagcgtg gccctccctc 14820
cagcagcagc tgccctgggc tgggccacgg gaagccctag gagcccctgg ggacagacac 14880
acagcccctg cctctgtagg agactgtcct gtcctgtgag cgccctgtcc tccgacctcc 14940
atgcccactc gggggcatgc ctagtccatg tgcgtaggga caggccctcc ctcacccatc 15000
tacccccacg gcactaaccc ctggctgccc tgcccagcct cgcacccgca tggggacaca 15060
accgactccg gggacatgca ctctcgggcc ctgtggaggg actggtccag atgcccacac 15120
acacactcag cccagacccg ttcaacaaac cccgcgctga ggttggccgg ccacacggcc 15180
accacacaca cacgtgcacg cctcacacac ggagcctcac ccgggcgaac cgcacagcac 15240
ccagaccaga gcaaggtcct cgcacacgtg aacactcctc agacacaggc ccccacgagc 15300
cccacgcggc acctcaaggc ccacgagccg ctcggcagct tctccacatg ctgacctgct 15360
cagacaaacc cagccctcct ctcacaaggt gcccctgcag ccgccacaca cacacaggcc 15420
cccacacaca ggggaacaca cgccacgtcg cgtccctggc actggcccac ttcccaatgc 15480
cgcccttccc tgcagctgag gtcacatgag gtgtgggctt caccatcctc ctgccctctg 15540
ggcctcaggg agggacacag gagatgggga gcgggtcctg ctgagggcca ggtcgctatc 15600
tagggctggg tgtctggctg agtcccgggg ccaaagctgg tgcccagggc aggcagctgt 15660
ggggagctga cctcaggaca ctgttggccc atcccggccg ggccctacat cctgggtcct 15720
gccacagagg gaatcacccc cagaggcccg agcccagcag gacacagtat tgaccaccca 15780
cttcctgtcc agagctgcaa ctggaggaga gctgtgcgga ggcgcaggac ggggagctgg 15840
acgggctgtg gaccaccatc accatcttca tcacactctt cctgctaagc gtgtgctaca 15900
gtgccaccat caccttcttc aaggttggcc gcacgttgtc cccagctgtc cttgacattg 15960
tcccccatgc tgtcacacac tgtccccatg ctgtccccac atgtccctga cactgtcccc 16020
catgctgtcc ccacctgtcc cggacactct cctccgcgct gtcttgacct gtgcccaaca 16080
ctgtccccca cgctatcccc ccatccccaa caatgtcccc cacagtttcc tcctgtcccc 16140
tatccccgac actgtcctcc acactgtccc cacctctccc tgtcactgtc gcccatgctg 16200
cccccacctg tcccaacact ttcctccaag ctgtcctcac ctgtccccaa cactctcccc 16260
cacactctct ccacctgtcc ctgacactct cccccatgct gtccccacct gtccctgatg 16320
ctgtcctcca cactgtcccc acctctccct gtcactgtcc ccatgctgtc ccctgtccct 16380
cacactttcc tccatgctgt cctcacctgt ccccaacact ctcccccact gtctccacct 16440
gtccctgaca ctgtccccca cactgtcccc acctgtccct gatgctgtcg tctgtgctgt 16500
ccacatactg ttggtgacct ggctctgttc tccaagttca agcctcagag caggcagtgg 16560
tgaggccgtg gcacctgggt ggcctgaggg gtgggcgggc cttgggggca gggctgtggc 16620
ctcgctcacc cctgtgctgt gccttgccta caggtgaagt ggatcttctc ctcagtggtg 16680
gacctgaagc agaccatcgt ccccgactac aggaacatga tcaggcaggg ggcctagggc 16740
caccctctgt ggggtgtcca gggccgccca gaccccacac aggagccgtg ggccatgctc 16800
agccatcacc caggccacac ctgcccccga cctcaccgcc ctcaacccca tggctctctg 16860
gcctcgcagt cgccctctga ccctgacacg ccccccttcc agaccctgtg catagcaggt 16920
ctaccccaga cctccgctgc ttggtgcatg cagggcgctg ggggccaagt gtcccctcag 16980
caggacgtcc ctgccctccg gcccgccagg tgctcacaca aaaggaggta gtgaccagca 17040
tcccaggccc ccactcaggc aggacctcgc cctggagcca accctgtcca cgccagcctc 17100
ctgaacacag gcgtggtttc cagatggtga gtgggagcat cagtcgccaa ggtagggaag 17160
tcacagcacc atcaggccct gttggggagg cttccgagag ctgcgaaggc tcactcagac 17220
ggccttcctc ccagcccgca gccagccagc ctccattcca ggcactcccg tgaactcctg 17280
acatgaggaa tgaggttgtt ctgatttcaa gcaaagaacg ctgctctctg gctcctggga 17340
acagtctcag tgccagcacc accccttggc tgcctgccca cactgctgga ttctcgggtg 17400
gaactcgacc cgcagggaca gccagcccca gagtccgcac tggggagaga aggggccagg 17460
cccaggacac tgccacctac cacccactcc agtccaccga gatcactcgg agaagagcct 17520
gggccatgtg gccgctgcag gagccccacg gtgcaagggt gaggatagcc caaggaaggg 17580
ctgggcatct gcccagacag gcctcccaga gaaggctggt gaccaggtcc caggcgggca 17640
agactcagcc ttggtggggc ctgaggacag aggaggccca ggagcatcgg ggagagaggt 17700
ggagggacac cgggagagcc aggagcgtgg acacagccag aactcatcac agaggctggc 17760
gtccagcccc gggtcacgtg cagcaggaac aagcagccac tctgggggca ccaggtggag 17820
aggcaagacg acaaagaggg tgcccgtgtt cttgtgaaag cggggctgct ggccacgagt 17880
gctggacaga ggcccccacg ctctgctgcc cccatcacgc cgttccgtga ctgtcacgca 17940
gaatccgcag acagggagac tcgagcggga gtgcggccag cgcctgcctc agctgtcagg 18000
gaggactccc gggctcactc gaaggaggtg ccaccatttc agctttggta gcttttcttc 18060
ttcttttaaa ttttctaaag ctcattaatt gtctttgatg tttcttttgt gatgacaata 18120
aaatatcctt tttaagtctt gtacttcgtg atgggagccg ccttcctgtg tccacgcgcc 18180
tcctgccccc ggtgggaagc acggtcagga ggaggctggt ccagctgcac ctcgggggct 18240
ccctgcatac gccccccgcc tcctgcagcc acacgcattg cccgagcgac cctccctggc 18300
ccctgtcgct acatggaccc ccggggtttc tcctcttttc tacatggatg cagtttctcc 18360
tcctgctggg cacggtgctg cctgccctgg tcactctgcg ggggacaggg cctccaggga 18420
aagctgggtc gaggctggga gctggctcag gctgcccagg cagagccaca gggagggcct 18480
tccagaacca accatggtcc gaagcgagag gtgggtgtca gatctgtgtg agtcagctca 18540
ggaccacagc ggggcggctc ccacagcaga catggatcct cccaggccta gagaccagga 18600
atctgagatc aggatgcagg cagggctggt ttctctcaag ccctctctcc ttggcttgta 18660
gacaccgtct cctccctggt cctcacatgg ccatccctct gtgtgcccgt gtcctaagct 18720
tctcttctta taagaacaca catcggatta gattagtgac cccctatgaa cttaatgacc 18780
tctgtaaaga ccccatctcc aaatagtcac attgtgaggc cagggattaa gacttgaata 18840
tatgaatttg taggggccac gatttaaccc atcacagtcc agactctggc ccccaaaatt 18900
catgttcttc tcacatgcaa aacacattca tcctgtctca gcatccccct gggcactagg 18960
tcatgtagca aggacggatt ttcaacagaa ataactattg caacagaaga aagagtccgg 19020
catgacctgg actcaccttc atctgtgcag aggccacagc cttgtaaagg gaggtggtag 19080
ggggagcagg gagggtgctc ggggctcagt cgtcggggaa gggaaaagtt gcccagcgct 19140
ggtcagcgtc cccgggatgg gacccgctgt gtctgtgccg gccactgttg aggtcaggat 19200
tctgtcctcc cagagcctgg agacacaggc cccatccttc ccaatgggga cacttcaggg 19260
agtggctctc aggtcccgag aaagaccctc ctgggtcaca ggaaatgcac agacatcggg 19320
aacggataga aggtcgtgtg gttgcggccc tctcagcaga taccctgaga aagggaggtc 19380
ggggttggtc caaacggtga gttctggtgc acggagcttt ctcaggcagg tgttgacggg 19440
gcaggggtcg gcctaggggt acggccagaa gctgttagaa actgttagtg tctgctcaag 19500
tctttacaag ccaaggttga ggccgagtgg agaggctccg aggagcctgg ctggaactca 19560
gtcaaggaca gggtcttgtt actgcagtgg ctgcggtggc tgcggtggct gcgaaatgcc 19620
gtcggagttg cctgtggcag gagagagacc atctcaccca ggaaggagga gtggttggat 19680
tcgtttgtgt ggcatcgagc agctggagct tcaccaaaca cagagttggg gactaaatcc 19740
ccagactcca ggccctgcca tgccgtggga aggctcgcca ctggagggtg cgctccaggg 19800
ggcctggcct gaactgggtg ctgaagccca gccctttaac tctcaggaca cgctgctgca 19860
gccccgcggg gggtgaggga gagagcacct ggggtgcagg gcgggcagct gctgcatcac 19920
cggctctatc ccaagcccaa ggatggcgtc ccagagatgc aggagagctt tgtccagaga 19980
aggtgccagc cctcagggac cctgctggag agatctccac cctctgccct tcaaggggcc 20040
ctacgggcct ccaggtgctc tggtggggtg ggctccagtc cactgtctga ggatggacgg 20100
cctggccagg ataaggaaag gaaacccagg acggtgccgg gctccgggtc attccgtgca 20160
ctgagcaggc tgagttggga agaagcagat gcttcctgca gctgctgccc cctgcagggc 20220
ctggcgcctg gaccaggttc ccctggggaa attgggcccc tccctgagcc acccggggcc 20280
cacctcccac tttctacctg ggaccgagca tcctccagag ggtcagccct cctgcgggaa 20340
caccatgccc agccccagga ccctccctca actctccagc aaggctgccc ctgcacaccc 20400
cccagcagcc catgctgtga tgtaacatga catcgtgtga catggtgtga tgtcctatca 20460
cagtgtgaca tccctggtgt gatgtggtgt gacatggtgg gatgtggtgt gacatggtgt 20520
gatgtccctg gtgtgaggtg gtgttggaca tagtgtgatg tgatgcgaca gatgtaacat 20580
ccctggtgtg atttggtgtg acgtagtgtg atgggtatga catccctggc ttgatgaggt 20640
ataatatgaa atgatgtgga atggtgtgac atgatgtgat gtgatgggac agggtgtgac 20700
gtccctggtg tgatgtgatg taacaggctg tgacatagtg tgatgtgggt ggtgtgacat 20760
gatgtgatgt ggtgtgatgg tgtgggacat ccctggtgtg atggggtgtg attaaacctt 20820
gattccatgc agcacatgtt tctgtgagca cagggttggg gctaaagtta caggttaaca 20880
gcatctcaaa gcagaacaat ttttctttgt acagatcaaa atggagtttc ttatgtgttc 20940
cttttctaca taggcacagt aacagtctga tctttctttt ccccacagtg tgacatggtg 21000
tgacatttct ggtgtgactc ttgtgttgtg acatttgtgg tcaccccagg atacagaggt 21060
ctctgtggcc aagggaaggg ggagaatgga accatctgag catgttgacc tggaggaatt 21120
ggtggccctt gagtccacga agcccaccct tccaggtgcc cctgccccac gtgacccaag 21180
tgggcttgca gagcagcaag caggactctg gttagacagg aggaaggacc tgccaccacg 21240
tggccttgtg aggagacaga gcgaggctgt gacctcggcg tccgcccagc acagggtgct 21300
gctgaagctc ctccggtcct ctcagcagcg gtctcagagc aaggcccaag gcaggctgaa 21360
gagaggggca gagggaggat gctggggagg caggtgtgag gggactgaga gcccaggttt 21420
cagctgagcc cctccacagg gaaggagcct agctgaacac ccatctcccc acacgctccc 21480
aaccctgcct ctgcccgacc acctcccaga gggcacctcg aaccctctgc tacccacact 21540
cagcaagggg tatggtgccc ccaccaagcc cagccagcaa agcctggcac agccacgcct 21600
gtgcccacca ctcccatggc caaggtcact gctaacatgg caggacagag ccaggcctgg 21660
aggagacaga acatcagtcc catggggaag ctccctgctc acacggcagg gccaggcctg 21720
gagaagacag aacaccccat ctggcatggt actcaggctg cacatgcctg ccacgaacgg 21780
gggccacgcg acaatgcctg ccacacatgg gggccacgca acgatgcctg ccacacatgg 21840
gggccacgcg acgatgcctg ccacacatgg gggccacgcg acgatgcctg ccacgcatgg 21900
gggacacgtg acacacacat acacacacgg gcctcacagg cacacaaatg cttgcgaacc 21960
cagcacccac ccagcacact caggcatagg ctccctgggc aggtcacaac ctcacgcctt 22020
gagctagtcc atgtgccagg cccgtcaccc acgtactcgt ccccggtgct agctattgag 22080
ccacaccgtc ttctctgtgg atccctccca gcccactcag cacaatggac atgctctctc 22140
ccgtccagtg actgcaccgg cctcttcccc tcagcaccca agtctggcca tctcccagga 22200
aacccggacc accacgggca gggaccacgt tcctcactgt ccacgtggac caccccacac 22260
ctgaccccag atgcagtcac actacgtcct gcttcaatat tgaaaagggg aaaagctgga 22320
ggagggtaaa gatgaaagag aaaaaagcaa gaggggaggg tcacattctt ctgaggcttt 22380
gattacatct cactgagccc ccacgttgca tgaaaaggag gggtggaggg agcaattaca 22440
catttgcctt gtgctcagta aatctgcact ttataagcaa ataaacagag tagaggaaga 22500
agtcaaatat gcattcgtct caggggcagg agggatgatt tcttgtctca ttttgtccca 22560
tgtcatgaag accgggctgt taatttatat tgtcagggtg agggaggcca cctgggtaga 22620
cctggcctat ctgctgctgc tctcagtttg gaaacaaaag gaaacgcatg actttttttt 22680
tttttttcat gactcagctt cccacctcaa ctgttctttt tggcatagtg actttagggt 22740
cctgagattt tattttcctt tcacaatggt caagatcaca ccctcagtat tcaggagagc 22800
tggtccaacc cagacccctg ccgtccctgg acgcttttca aatacgtgct gcagtctctg 22860
acactctctc accatggtag aaactgaggt cttggtgagt ctgcagcccc tgctcatggg 22920
gacaatgcag gctgaaaccc gcatttctga ccccaaagct cctgttcctt tcactcaccc 22980
ccacaccagc tctttgagtc cagagctttg tccttgcctg agtcctaccc tcagggacag 23040
gggcccaacc cagccaccaa cacatcatac cctgagaggg tgccaggagc ccagagatgt 23100
ttggagagca cagtagccct ggaagctctg tggagatgct gcacatttct ctattcaaca 23160
gatactcgcc aggtggccag cagcagagat gccacatggc atggagctcg ccttggccaa 23220
caggacaggt gtggggttgg gaggccttcc cagggcactc cttgaagcag agctgtgggg 23280
aaaagttggg gccaatctca gatctccccg tcaacaccgg gtctcctgcc ctcctgggcc 23340
acagaaaact aagctccgtg gatactgcgg ctgggtgggg ccgtggggga gaagaaatca 23400
caacgagtta aaagatcatt ttctaaaact gttatgatca ggactcacat aaccatatga 23460
cgacacattt cagagatgct ctttatctca ttaattaagg tgtcgtaacc agttcaaagt 23520
ggaattctaa gtactacact tacataattg attcaggaat gctaaaagga gttcatagat 23580
agatgcaaaa ctggcctttt ccctggaaga tgaggagcaa ttcattgtcc ttccaaagat 23640
gagaacttga atttctacca actcaaagag cttttgcatt gctatcaatt atgtacaact 23700
tagagcagtg gtccccaaca tttttggcac caggaaccag ttccatggaa gacaattttt 23760
ccacagacca ggatcggggg atggcttggg gacaaagctg ttccacctca gatcattagg 23820
cattagggtg tcataaggag tgtgcaactt agatcccggg aatgtgcggc tcgcaatagg 23880
gttcgctcct gtgagaatct aatgctgcca ctgatctgac aggaggtgga gctcgggcag 23940
gaatgctcac acacccctca cctcctgctc tgtggcccag ttcctaacag gccatgaacc 24000
ggttccagtg catgacccag ggattgggga cccctggctt atagaggtgt aaaatagttc 24060
aaaggaaata aaagatgcag agctccacag aatgaaataa cctggaagag tgtacaagac 24120
gatgccttgc tttccatgga aggcacctac taatttttct caatgtttcc tataaacata 24180
tataactgac tgacagaaac agatccataa tataaagaag acccctgtaa accaatgaga 24240
aaaaaaatca aataatccaa cgaggaatag gcaagagaat tgaacagatg ttttacagaa 24300
gatatccaaa tagccactaa acatatgaaa aggtgttgaa ccacactagt caacagggaa 24360
atgaaaatga aaaaccacat gagagaaagt agttctgatt ccagtaatgc tagagcagct 24420
aatatcagac tagccctttg gcagatggca attataaaca ctggaaacac tgtaagcaca 24480
cacaacaccc acacacacca attgcaggca ctggaacatg accagaagta ggcaaacact 24540
agtaaggatt attccgtgaa atattcgtct gaagtcacac cccagtgcat gtaatgggtg 24600
cagctagagt ttaagcagga aactgcagcc ctcctggtga ggagtgggat gcagggctgc 24660
attttcagag cagctggaaa tgaagagaag atgtccataa aggagaagct caccgaaggg 24720
aaaccacaca atctgcaagt aaactccact gaaacctctg gccgatccct taggtgtgca 24780
tgggtaggga aaactccaaa gggcccagca gaaagcaaca cctgtaagtc gagagaactg 24840
agattccagc tactgccaac tgccaggcag acagacttgg gagtttgagt caactcaagc 24900
taactgctaa cattgaaaaa aacaattaat gctctgctaa gaaagaatgc aaaccccata 24960
gcctgtacgc atgttatcaa catcaggtgc acatccaaaa ttaccatgga tgcaaagaaa 25020
catgaaaatg tgatccatag tcagaagaaa aagggatcaa tggagatcaa ctccaagatg 25080
acctagatgc agatacagtt atcagacaag gactttaaag aagttatgtt aaacatgttc 25140
aaagacttaa aggaaaatac tattataatg agtgactaga tggggaatct ctataagaga 25200
cggaaaatat ttacaagaac caaatgaaaa ttctagaact gaaagtatga ttctgaaatg 25260
aaaaacatca tttttcagag cagggtgaga atggacatgg gactcagagc tgagcaggcc 25320
tggtgggccc caggagggag acacagagga ctgggggatt tcaaggctgg cagaggccag 25380
agatggatcc ccagctggga ctggacctgg gcttatggga gcaacaggtg acccatcctc 25440
cttcctgggg gcccaccctg cccggcccct ccagcccagc acaggcattg gatagaaccg 25500
ggagagagca ggccaggcac tgaggcctct gccccaaatg cccacagcct ggggaaaatg 25560
agcagataga tgggggggca agtggatccc caggcacacc cacacagtgc acacagcccc 25620
acctgggcca gagggggcag gaggctcgcc acccctgctg tggtttctcc cacacttgat 25680
gcaggtgata ttcctctgag attgtggact aagagttggt gctggaaggg gttagccatc 25740
ttggagatgt tgctatgggg tgcagggatt ttgcatgtga gaaggacatg attatggggg 25800
gagcggaggg caaactgttg tgggttaaaa tgtgtcccct ataaattcat gtgttgaagt 25860
cctaaccccc aggaccacag aatgtgacct tgtttggaaa cagtctttgc aactgcaatc 25920
aagttcagat gaggtcaccc tggagtaggg caagcctctg atccaatatg actgctgtcc 25980
tcatgaaaag ggggaatctg ggtacagaca gcacgtgggg agaacaccct gtgaagatgg 26040
tgctgcttcc ataagccaag agcagcagag acggccggca aagcccagca gcaaggagag 26100
agcctgggac agagtctccc atgacacaga ggtgccagcc ccgccgaggc ctccatccca 26160
gatgcccggc ctccagaacc aggacggaat aaacgtctgt tgtttaagcc acgcagtctg 26220
gggtgctgtg ttgccagggc cacagttaac ggatacgagt gttgtcctga gctgccagcc 26280
ccacaggctg cacgaggcct ccctgcccca gcccagtgca gactccccag ccccctgggt 26340
gtgccatggg cagtgcgggg cccctcactg catcctcccc cagcctggga ggttgagccc 26400
attatgagct ccatggggtg aagccggagc cagaagctgg gagccgactg ggagcctgcg 26460
gctggaggat ggatttcccc agggacccac acgtgcacct ccacctgtct cctggacatt 26520
ctctctgagg gcagggctgg tgtcagctca gggatccagc agggacacaa gggtgggccg 26580
ggtccttgtg gagagcacat ttagtgggag ggacatgatt tcccttcaaa gtgcccattc 26640
tggatgcttc ctggtccacg ctggacactt cctgttccac gctggacgct tcctgttcca 26700
cgctggacgc ttcctgttcc acgcttgatg tttcctgttc catgctggat gcttcctgtt 26760
ccatgctgga catttcctgt tccactctgg atgctccctg ttccattctg gatgcttcct 26820
gttccatgct ggacatttcc tgttccactc tgcatgcttc ctgttccact ctggatgctt 26880
cctgtgcgaa acctcctcgg gcttttggtc tgcccagtcc ctctggctgc atctcgtccc 26940
ccgctacctc ccacctccac atccgtcctt gcccagctcc tctctctctc cagagtttcc 27000
acctggcaag gtccctgatg agctcagtcc aggctccccc agcacaggta ggagcctagc 27060
acctgccctt ggacctcccc accctgcatg atgccagcat ccccaggccc cagggaggcc 27120
ccatttctct ctctactgct ggcccagtgg ccctggagtc ccactgcaac tcgggtgtgc 27180
ccctgacctc tgaggaagtt aagtgtcctg tccctagcca ggctatcccc tctgctcagc 27240
cccagggccc tgccccttac cccttcccct cacctgcacg ataggctctg gccaactctg 27300
cccaggccct gaatgggccc ctctggctcc cctctgctgc tacactgccc tgcaccacct 27360
ccactcagct tcagtgtgtt catccacctg tcccaagtcc cctcggcccc caggagcaca 27420
gctggtggcc ctggttcctg gcagcccatc ttgttccttc tggagcacca gcctcagagg 27480
ccttcctgtg cagggtccac tcggccagcc ctgggaccct cctggtctca agcacacgtt 27540
ctccctgcag ccagacctgc ccctgcctgt gagctcagac ctgagccttg gaacgtcttc 27600
ccttctccat cccagctcgc ctttgccagc tgctcagtgg gatgaactca cactcccctc 27660
cctccaccat gagtgagagt cagctggaga gatgcccagg ccaaagcagc caccagggcc 27720
cagtgggggg ccagaagctt caggtgagag gcccaggtat tgagaggctg agaccatggg 27780
cagaatggtc ataatcgctg ccagtctcag tccagcccca gggactcaga gacagagaaa 27840
agagcagcac acaaggtccg ggctccccac cttctcccgt gagtatgggg gagtatgggg 27900
gcagccacca cccccatccc cacacaccca tgaggcagcc tcggctctgt gtggactccc 27960
cctcgccctc tgacacagaa accaccagaa gaaaagggaa cttcaggaag taaggggtgc 28020
cgctggtttc aatcctgttc ttagtctttg cagcgtggag ttcacacccc tggggacctg 28080
ggacctgagc tgtgatttcc taggaagaca aatagcggct gacggcgggg gcggggccgc 28140
ccacatgtac ctcgccagaa caggaagggt tgagaccccc acctcggtga gtggggtcag 28200
cacagggcag gggcacaggc tcgggaggag gacagcctgg gcgcagccgt cggcgctcct 28260
agacctgagc tgctgaacag gctgcaagag gctggggaga cgcgggcgcg aggccagccc 28320
cacatggaag cccaagcgga gccagcacgg gggaggtggg cagccttcag gcactgatgc 28380
ccacccagtg cgagacgacg gggaccgtgg gcaggggctt ccaagccaac agggcaggac 28440
acaccagagg ctgactgagg cctccaggac gaccgggctg ggagcacgag gaacatgacg 28500
ggatgcggca gaaccggctg tggggtgatg ccaggatggg cacgaccgac ctgagctcag 28560
gaggcagcag agcgagggag gaggagaggc cccaggtgaa cggaggggct tgtccaggcc 28620
ggcagcatca ccagagccca gggcagggtc agcagagctg gccgtagggc cctcctctca 28680
gccaggacca aggacagcag gtgagccggg agcagagcag cgagggtgag tgtggcagca 28740
ggacagaagg gtggaagcca aggagcccag aggcagaggc agggacaggg gagggacagg 28800
ggctgggctc agagccagct gatggggctg gggcacctgc tggcggggag cagggctgtg 28860
gtcagcagcg gagaggaggg gagagctgtg ctgagtgcac gggcgggagg agggaagagt 28920
ccagggaggc ccagaaaggc ccagagtgca gcaggcctgg ggcgagggga ggggctgagg 28980
cccagcagag cagaggccac tgaggagctg aggttccgga gaggcttcca gagcaggagc 29040
agtgcaggga cgggaggatc cgggagctca tccaggaggg gcacataggc aaggggctct 29100
gttggggaga cctgactgga cactggggct gctccacagc atagggaaca agccaagtgc 29160
tgcaaaaaca aaaatgaggc cagaaaaaca gcccaaacct ggacagaggg tgccaggaca 29220
ggcagggggg caacagtggc ctgagtgaca ttgctgcccc gggttgaggg aggacagagt 29280
gagcaggggg caggcattgg agttcagggt accaggaccg agcagccaca ggtgagcagg 29340
gcaggtgggg gtagaaggag cagggggcag ctcctggaac tcaggggacc agggcagagc 29400
agccacaggc aaacaggaga ggggaggggg ggcaggagga gcagggggca gctcttggag 29460
ctcaggggac cagggcagag acgccgcagg tgagcagggg caggtggggg ggcaggagga 29520
gcagggggca gctcttggag ctcaggggac cagggcagag cagccacagg tgagcagggg 29580
caggtggggg gcagaaggag tagggggcag ctcttggagc tcagaggacc agggcagagc 29640
agccacaggg gaggaggggc aggtgggagg caggatgaac agggggcggc tcctggaact 29700
caggaaacag gggagagcat cagaaggtga gcagggccag tgggaggttg cagagcaggg 29760
gacagctcct ggagctcagg ggaccagggc agagccgccg caggtgagca ggggcaggtg 29820
gggggcagga ggagcagggg gcacctcctg gagctcaggc gaccggggca gagcagcctc 29880
aggtgaaaag ggccggtggg gggcaggagg agcaaggggc agctcctgga ggtcagggga 29940
ccagggcaga gccgccgcag gtcagcaggg ccggtgggag gcaggacgag caggggacag 30000
gcactagagc tcagggcaag gcagccacag gtgagcaggg ctggtgggag gcatcactca 30060
gctcctagac tttggcagga gctgggtagt tgccggcagc agacagctga gagctggtga 30120
aagtgcagtg cagcctcctg gtgccgggaa gggagtgtga gtccatccca ctgagcagtt 30180
ggcaagggcg agctgggatg gagaagggaa ggcattccag ggctcagggc tgggctctca 30240
ggcaggggca ggtgtggctg cagggggaac gtgtgcttga gaccaggagg gtcccagggc 30300
tggccccagc ggaccctggg caggaaggcc tctgaggctg gcgccccaga aggagcaaga 30360
tgggctgcca ggagccagga ccatcagcac aatgaagctg agtggaggtg gtgcagggca 30420
gtgtagcagc agagggctgc cagaggggcc cattcagggc ctgggcagag tcagccagag 30480
cctgtggtgc aggtgagggg aaggggtggt gagcggggcc ctggggccga gcagagggga 30540
tggcctggct gagggcaggg cgcttagcct cctcagaggt caggggcaca ccccacctgc 30600
agtgggactc cagggccact gggccagcgg cagagagaaa tggggcctcc ctgtggcctg 30660
ggggtcctgg caccatgcag ggtggggagg gccaagggca ggtgcaaggc tcctacctgt 30720
gctggggggc ctgggttgag cccagcaggg accttgccgg gggaagctct ggagagaggg 30780
aggaggtggg ctggtggccg agaaggccag gccagggctg ggagggtgag gttgtggtga 30840
ctgagcctcc agaagtaatg caggacactg ggaggcaggg ggcatccagg cactcagggc 30900
cctgacctgg gctgctgcac actggggcta aggggaaagg aggggagagg ctgaggagga 30960
ggctccagga ggctattcca aggcaggggg ttccggggcc ctggggctga agggcgccga 31020
ccctatgcag tgtctggccc ctctgctgca cagaagaaaa gggccttgga gggcagaggg 31080
caggctatga ccagggccct gggcaagtca ggcccactca ctagcggagg gccacgctgg 31140
ggcggcaggg tcaggagctt caggggactc gggggaccca cgagaagcca tctgagaaca 31200
gtgtccactg gtcaagccag gcacccataa aaggctggag tggggccaat gggcatgagc 31260
cgtccctgag gtggcaccga tggccagagc tgaggccaag ctagagacac tggactgtgc 31320
tgactcccgg caggcacaga gcgctgacct ggctgccgag ccccgccccc taggctgcag 31380
gggtgcctgc agaagggcac cacagggcca ccggtcctgc aagctttctg gggcaggccg 31440
ggcctgactt tggctggggg cagggagggg gctaaggtga cgcaggtggc gccagccagg 31500
cgcacaccca atgcccgtga gcccagacac tggaccctgc atggaccatc gcagatagac 31560
aagaaccgag gggcctctgc gccctgggcc cagctctgtc ccacaccgcg gtcacatggc 31620
accacctctc ttgcagcttc caccaagggc ccatcggtct tccccctggc gccctgctcc 31680
aggagcacct ccgagagcac agccgccctg ggctgcctgg tcaaggacta cttccccgaa 31740
ccggtgacgg tgtcgtggaa ctcaggcgcc ctgaccagcg gcgtgcacac cttcccggct 31800
gtcctacagt cctcaggact ctactccctc agcagcgtgg tgaccgtgcc ctccagcagc 31860
ttgggcacga agacctacac ctgcaacgta gatcacaagc ccagcaacac caaggtggac 31920
aagagagttg gtgagaggcc agcacaggga gggagggtgt ctgctggaag ccaggctcag 31980
ccctcctgcc tggacgcacc ccggctgtgc agccccagcc cagggcagca aggcaggccc 32040
catctgtctc ctcacccgga ggcctctgac caccccactc atgctcaggg agagggtctt 32100
ctggattttt ccaccaggct ccgggcagcc acaggctgga tgcccctacc ccaggccctg 32160
cgcatacagg ggcaggtgct gcgctcagac ctgccaagag ccatatccgg gaggaccctg 32220
cccctgacct 32230
<210> 70
<211> 326
<212> PRT
<213> Intelligent people
<400> 70
Ala Ser Thr Lys Gly Pro Ser Val Phe Pro Leu Ala Pro Cys Ser Arg
1 5 10 15
Ser Thr Ser Glu Ser Thr Ala Ala Leu Gly Cys Leu Val Lys Asp Tyr
20 25 30
Phe Pro Glu Pro Val Thr Val Ser Trp Asn Ser Gly Ala Leu Thr Ser
35 40 45
Gly Val His Thr Phe Pro Ala Val Leu Gln Ser Ser Gly Leu Tyr Ser
50 55 60
Leu Ser Ser Val Val Thr Val Pro Ser Ser Asn Phe Gly Thr Gln Thr
65 70 75 80
Tyr Thr Cys Asn Val Asp His Lys Pro Ser Asn Thr Lys Val Asp Lys
85 90 95
Thr Val Glu Arg Lys Cys Cys Val Glu Cys Pro Pro Cys Pro Ala Pro
100 105 110
Pro Val Ala Gly Pro Ser Val Phe Leu Phe Pro Pro Lys Pro Lys Asp
115 120 125
Thr Leu Met Ile Ser Arg Thr Pro Glu Val Thr Cys Val Val Val Asp
130 135 140
Val Ser His Glu Asp Pro Glu Val Gln Phe Asn Trp Tyr Val Asp Gly
145 150 155 160
Val Glu Val His Asn Ala Lys Thr Lys Pro Arg Glu Glu Gln Phe Asn
165 170 175
Ser Thr Phe Arg Val Val Ser Val Leu Thr Val Val His Gln Asp Trp
180 185 190
Leu Asn Gly Lys Glu Tyr Lys Cys Lys Val Ser Asn Lys Gly Leu Pro
195 200 205
Ala Pro Ile Glu Lys Thr Ile Ser Lys Thr Lys Gly Gln Pro Arg Glu
210 215 220
Pro Gln Val Tyr Thr Leu Pro Pro Ser Arg Glu Glu Met Thr Lys Asn
225 230 235 240
Gln Val Ser Leu Thr Cys Leu Val Lys Gly Phe Tyr Pro Ser Asp Ile
245 250 255
Ser Val Glu Trp Glu Ser Asn Gly Gln Pro Glu Asn Asn Tyr Lys Thr
260 265 270
Thr Pro Pro Met Leu Asp Ser Asp Gly Ser Phe Phe Leu Tyr Ser Lys
275 280 285
Leu Thr Val Asp Lys Ser Arg Trp Gln Gln Gly Asn Val Phe Ser Cys
290 295 300
Ser Val Met His Glu Ala Leu His Asn His Tyr Thr Gln Lys Ser Leu
305 310 315 320
Ser Leu Ser Pro Gly Lys
325
<210> 71
<211> 1901
<212> DNA
<213> Intelligent
<400> 71
gcctgacttt ggctttgggg cagggagggg gctaaggtga ggcaggtggc accagccagg 60
tgcacactca atgcccgtga gcccagacac tggaccctgc ctggaccctc gcggatagac 120
aagaaccgag gggcctctgc accctgggcc cagctctgtc ccacaccgcg gtcacatggc 180
accacctctc ttgcagcctc caccaagggc ccatcggtct tccccctggt gccctcctcc 240
aggagcgtct ctgagggcac agcggccctg ggctgcctgg tcaaggacta cttccccgaa 300
ccggtgacgg tgtcgtggaa ctcaggggcc ctgaccagaa gcgtgcacac cttcccggct 360
gtcctacagt cctcaggact ctactccctc agcagcgtgg tgaccgtgcc ctccagcagc 420
ttgggcaccc agacctacac ctgcaacgta gatcacaagc ccagcaacac caaggtggac 480
aagacagttg gtgagaggcc agcacaggga gggagggtgt ctgctggaag ccaggctcag 540
ccctcttgcc tggacgtacc ccggctgtgc agccccagtc cagggcagca aggcaggccc 600
catctgtctc ctcacccgga ggcctctgcc cgccccactc atgctcaggg agagggtctt 660
ctggcttttt ccaccaggct ccaggcagcc acaggctgga agcccctacc ccaggccctg 720
cgcacaaagg ggcaggtgct gcacttagac tggccaagag ccatatccgg gaagaccctg 780
cccctgacct aagcccaccc caaaggccaa gatctccact ccctcagctc agacacctct 840
cctcccagat ctgagtaact cccaatcttc tctctgcaga gcccaaaacc ccatgttgtg 900
acacaactca cacatgccca ccatgtgcaa gtaagccagc ccaggcctcg ccctccagct 960
caaggcggga caggtgccct agagtagcct gcgtccaggg acaggcccca accgggtgct 1020
gacacgtccg cctccatctc ttcctcagca actgaacccc tggggggacc gtcagtcttc 1080
ctcttccccc caaaacccaa ggataccctc atgatctccc ggacccctga ggtcacgtgc 1140
gtggtggtgg acgtgagcca cgaagaccct gaggtcaagt tcaactggta cgtggacggc 1200
gtggaggtgc ataatgccaa gacaaagccg tgggaggagc agtacaacag cacgtaccat 1260
gtggtcagcg tcctcaccgt cgtgcaccag aactggctga acggcaagga gtacaagtgc 1320
aaggtctcca acaaaggcct cccagccccc atcgagaaaa ccatctccaa aaccaaaggt 1380
gggacccacg gagcgcgaag gccacgtgga cagaggccgg cttggcccac cctctgccct 1440
gggagtgacc gctgtaccaa cctctgtccc tacagggcag ccccgagaac cacaggtgta 1500
caccctgccc ccatcccaga agatgaccaa gaaccaggtc accctgacct gcctggtcaa 1560
aggcttctac cccagcgaca tcgccgtgga gtgggagagc aatgggcagc cggagaacaa 1620
ctacaagacc acgcctccca tgctggactc caacggctcc ttcttcctct atagcaagct 1680
caccgtggac aagagcaggt ggcagcaggg gaacgtcttc tcatgctccg tgatgcatga 1740
gggtctgcag aaccactaca cgcagaagag cctctccctg tccccggggt aaatgagtgc 1800
gacggccggc aagcccccgc tccccgggct ctcgcggtcg cacgaggatg cttggcacgt 1860
accccgtcta catacttccc aggcacccag catggaaata a 1901
<210> 72
<211> 32230
<212> DNA
<213> Intelligent
<400> 72
gaattcacca ttttaaagtg tacaattgag tggcatttag tacattcacg atgttgtgca 60
atcatcactc ctattattac tctgtaaact ttacaaattc atcgtattta tttatttaat 120
ggttgttaca gtttgcaact aaaatagaag gaaatacatc aaaatattag cagtggctct 180
tctgggtgaa gtacaagggg caaattgttt tctcctgttt gtttttctgt acacgttgtt 240
tactgtgtca cattgtttac tgtgaatagt tactatttga aactaaagat caagggcgat 300
aaactgtatt ttaagaggaa gtcagaaaac aaacaaggtg gccctctcgt atgctgtgct 360
gacacctgtg tccctgtagc ctcaactacg cctgttgccc ccacctgcgc ctgaagtttg 420
aggtcgctgg tggcacctct gtgccagggg gccctggaac ctctcctagg atggtcccag 480
agaaaggaga gagatctgct tcctggaatc tcagctctag atgctttggt caactccatg 540
tcatctgtgt ttgataagct tgatttccat ttgttttggc ccctctttta gtgtgctttt 600
tgttagcaga aactcacgaa ctagagaact gcaggtcccc caggggagtg ggttgagatg 660
tttttgacat cagccacctc tttctcccac agttttgtta ttaaaacccc attttaacaa 720
ccttgaaaga caggttttaa aagaaagttg caattttctt acaattctac tgcttaatta 780
aaagagtagg ccctgtggtt ccctttcccc atcctggtgg tgttctccct gcccctgtgg 840
tggtgttctc cctgcccctg cctctcacca gtgtatgctg ttcccaggtg gcagtaatcc 900
tatctcaggt ctggcattcc aaggcaggct cctgctcctg ggtggggagg ggcctccatg 960
ctgggttgaa tgtctgtgct ttgctgtccc ctgacccaca gagtgccctt ggacaggaca 1020
taggtctcag tttcctaagt gagagtcccg gattagatgg actgtggtta accctttatg 1080
tgtcatggcc tctttctgta taaagccaca gatctttccc tgcaatgagc atttatacag 1140
acacttttca gggttttgtg aacccgtgag ctggacatcc tagagctctc cttcaatccc 1200
atggcctcta gggtaccctg ctctggaaag gcaagactgg gcctcttttt tgggaccccg 1260
gagggcagac cttgggtttc gtcgtggcac ccctgctggg tgatgtgccc agggctttcc 1320
acgatgatcc cactgaatcc tcacatagcc ctgaggggaa gctgccacca tcatcacctc 1380
cacatcacag aggagtacac aggcaggaca gtcacactcg gacaagtggt ggagccagga 1440
cacaaaccca ggtctgtctg gactctaagc ttaggctctt accatgaact gtgatccaac 1500
catcgggaga gtcagcccaa tgaccttcaa gttccctcca atgctaaggt cacacctgag 1560
aagcttgcta gggtttctaa agcatcttcg tgcacatatg tccttccagg gttcttccca 1620
gcagtttgtg agatgggcag ggcagatgaa gggaaaaggc ttcaagacat taaggaaagg 1680
gcccaagatc acacccgagt caggatcaga gcaggaattg gaatctaatc tctacacaga 1740
gttgccagat accaatctgt gcttctcatg gttagaattt acctacttat ccaactattc 1800
acccatccaa ctacccaccc acacatgtac ccaccagtcc acgcattcat ctatccagcc 1860
atccactcac ccacccaact atccactcat ccattcacct accaatccac ccactcatcc 1920
acccatcaat cactcaccca tctatacatc catccaccta cccctttctc cctccctcct 1980
tctttccctc cctccctttc tttcctcatt cagactgttt attgagagcc ttgaaggtca 2040
ggcacttgga tggctgctgg ggagatgaag cttgaagatg tgtgaacggg ctgctcctct 2100
tggagacatc atcttttccc tcatcagtga gggttctgga aggggaatgt gggttgggag 2160
gcaggcagga tggagaggtg gctgttgagt tcctgccctt tgggttttgg gtcacagtac 2220
tagactcata gaattgggtt aaaaacttgt attttttttt ctaaggagaa gctggaaagt 2280
gaacaagtaa gatagggcgt ctggctcctt gctgtgtata gaacagatac ccagcaatga 2340
ccataggtgc agagtttatt tatgtagaga ctttttgaat ataagaaaag aaatgacaaa 2400
tatatatgag ttactatata atgaatataa gtataattaa aataaaccaa ctataggtag 2460
tgcagggtga gtttccaata ataaattcta aaccaacttc catcattcat ggaaccagat 2520
attctattca ggaattaata tgcattctcc catacatttc ctattataca catgggaggt 2580
agctactcat attaaatcaa tatcaaatag atgggaacat gaggagagag attagctacc 2640
aaggtaaatt gtcatctctc agtggcagag aaatttgtca accgaggtct tcctagaaat 2700
atgctctgac ctaccataca attcttcctg cctgaggaac tggtaaaaac tctccaagtc 2760
catcctggct tccttctttc cttcccaact tctgctcatc ctgacctgac cttgtcccaa 2820
gctgctctat ggcttttatt gctctttgca gaaatcgctt aaactttttg tttgcagttg 2880
ctccctcctc tgtgtttaac tgtattttaa gggggggttc attttccaat cctctttgct 2940
aaatgtcggc tgctaggtac tcatcccccc tggaatgccc tctctttcca tttttatgac 3000
tcagcaactt tccctgggct tcctgcctct gagctggctg gagctgtgag acaatttcgg 3060
gctttgggca gcacctaaga catacaggat gcgaatccat gttaggatcg tagtgacctc 3120
ttccatataa tcccccattg tactactcct caagagagaa cactctgtct tctcatcagt 3180
gtaatctcaa accctgcacc ctgactgttg tgggtgtagc agacacacaa gaaatatttg 3240
ctgaatgtta agtgaattgg aataaacatg ttgatttaag tgacaaaacc ttctattttt 3300
cataataata aatgtataat gattgtcaaa aaatgaaaaa agttagatgt acaaaatgaa 3360
aaccaatatt acctacagtt tacccccgca accggtagcc ccggggaata gatgtggata 3420
cggatgtgca tctaggtatg gataaaaatg cagggattca tgcacacaca ggtcacgtct 3480
tatctggtgg cctctttggg ataatatgtt caaggctttt cagatgccat tcgcatcatc 3540
gaatacagca tttttatagg atcttacatc ttaaattggc ttaatgtttt gttctccgat 3600
tataaaatct gaaaacagga aaaattaaat aagaatacaa agcaagtctc tgatcctgca 3660
ctgcccaaga ggccctgtta gcgcgttggt atggcgcctt ccagatcttt ttctgcatga 3720
aatcatgggc ttatcacaaa gatgggaact tctttcctca cttcttcttg ccctgttgtg 3780
aacatctgtc tatggccctt ctccaaggcc atctggggat gtggatgtga ggctggcatc 3840
tgctctcggg ctcttttctg tcacgttttg ctgttagctc cctggctaac atccacatgc 3900
actggctctc tggcatctcc atgataaatt cttatgagca ggatttctgg gtcaaaagag 3960
agtgcattcc caggctgtgg agacagggga cacgttcagg agggcctaaa aggctgaacc 4020
gtgtctcagc cttgaggcct ctcagaatcg ccagcttggg aagttaggag gcctgtggtt 4080
gctcatcact ccctcaccaa ctcgttctgc ccagggaagg tcctggggtg ggggcttcag 4140
agccctgtcc tggccacccc cctccctggg gtcctgctga caatcagggc cactgctggc 4200
tggttctgag atgccttctg gtggaccctg ggacccagga tggagctcag ggtgtgggga 4260
ggcagccagg gggcagcatc aggcccaggg gctggactag gagggggtgg ggtggggcgc 4320
aggctctact gcccccacct gtgagctgca caaacatcca gcagcagccc tgaaactgcc 4380
ccatgctcct cctgggccac acctgggcct gtttgtcact catcccatgc ccgggtggcc 4440
atgagctcag tttctcttcc tcttattttt ctccttttgt cactctgagt tctggtttca 4500
gccaacttgg ggttaaattt agcctgggga tttccagggg tggccagctg caggcagggc 4560
caccagagct gggaaagcgc atcccccaac cccatccctt ggcctggccc ccaccctact 4620
cccatctcag gcctccctgg ccaacccctt cacccaggaa tctgctggtt tcctgaatgg 4680
ctggcactcg gggtccctga cccagttcct ccttgaccag agggaaggct gggcccagga 4740
aggcaaaggc atttgcccag gttcacacag tgtcacccgc aggcccaggc aagagcaatg 4800
actgagggta ggtgagggtc cccataggcc aggcacagct taggcatcat ctcaatccgc 4860
aaacctacct tgtggggagg gactcttatc acccccttgg gcagatgagg aaactgaggg 4920
ctacagaaga gaagcagatt gctcaaggtc aagggttgat gagggctgag catggtgggg 4980
ggaccccttc tctgtctgac actgaggtct gggctcccag ggcagatgcc cctttgggaa 5040
gaacagtgct ctgggctccc acaggccttt gcagccaccc tccttccttg catctcccaa 5100
ggcacaggga aggaatggcc atcagggcct gtagccctaa ctctcatcca tgctgctttc 5160
aggcctcttt tctgcacccc tgaaatgggg ctggagctgt ggaatggtgg aggaagtgaa 5220
caatctggtc tctggcagag ggcagtggtc cacacagcca ccctccatac aggtcttctc 5280
catgcaggct cctccacacg ggtcccacca cacagcgccc tccacacggg cccctccaca 5340
caggtcccct ccacacaggc cccctccaca caggcaccct ccaacagatc ccctccacat 5400
gggcccctct acctggcacc ctaccgacag gcccctccat gcgggcccct tcacacatga 5460
tccctccacg cgggcccctc cacgcaggcc cctccacatg ggcccctcca cacatgattt 5520
ctccacacag gcccctccac atgggcccct ccacacatga tccctccaca cgggcccctc 5580
cacacatgat ccctccacac gggcccctcc acacatgggc ccctccacac gtgggcccct 5640
ccacatgcca ccctccatac aggtcccctc cacatgggcc cctctacatg ggcccctcca 5700
cacaggggcg cctatgtgag ctcgggcaga tccctttctc tcctggtctg tttctccatt 5760
tgtcagatgg gaggccctgg gctggaagtc aggacaccac agagctggct ctggcttttt 5820
gggatctaac tgctctgggc ctcagttttc ctacctgtga aatgggacca tgattctggc 5880
tgtggcctca cagaatccct gagtggctca ggtggataac atgtgtccac gtgttttata 5940
aatggtacgg gacgataagg ccactcaata gcgtctcaac acaggatgca gctacctgta 6000
gagttgcaga tgtggtcaga cctgaggttt agggcctcta ctctcggcct tgctctctct 6060
gggccctgcc cctgcccctc tgcagagctc tggggcttgg ggcactctgg tccactggcc 6120
tggaccagca tgaatgttca tggccttggt ccaccgtcca acccagagaa ctgtgcaccc 6180
tgcagggccc tgccttgggc ctggctccca gcatcctctg ctcattccct ctcctccacc 6240
gggtggtcac tacctgtgtc ctatgcaggg cccagacctc ttttctccct tgttccctgc 6300
ccccctggaa gcctggtcca tcttggagcc catccatgtg gcacagactc caaggacttc 6360
ctgggtatta agtagggtgg caggccaggt gacgtggggg acagagtatg gggcctttga 6420
ggtgagcttt cagggtgctt ccatgagggc ccttgtgcac tactgtggcc ctgtgggaag 6480
aagggatgct gtggtcactc ctataccttt gctcacactc acccctaaca cacccgtcct 6540
ctctctgccc ttcagtcctt gatccagctc ctaggcctgt ttgaggttgc tgctgccacc 6600
aggctacctt tgatgaccac atggaatccc cagtatctcc tgccccttgt cttcttcaag 6660
caagggggtc tcatctgcaa tctgagctct gggctgggcg gggacaagta cccccccttg 6720
cttgctttac ttcaggaact ggcctgggtg gctggcatcc tgtgcatgtt gaggggacgg 6780
tggtggggga tgccagtgga tgagctgatt gaagatggtg ctgggtctag ggccaccctg 6840
ttcagcctcg tgggtgggcc tgtggggagg aaggcagagg tgggggcact catccctggc 6900
ctgcccaccc tacagttcgc atcttatgtg tcaggtgaca tgtgcaatgg ctacgtgtgg 6960
cgggcctggc tcctggcttt cctgggccaa gggagctcca ggctggtgtc ctctaagaat 7020
gagctggtga agtcccacag gtggatggga tttgccgtct gcaggggtga acccaggccc 7080
tgaggctggg tacttggtct cctcccatac tctcatcaga acctggagcc ctggaatatc 7140
ctgggaacgt ttcctccaca tggagaaaga cagggaggtc tgtaacgggg gcagtgggta 7200
ggatctggtc atcggacagg gggcattaag cctcaccaca gtggcctgtt cctcacacct 7260
gtcaacctct ctttgacctc agcatctaga cccagcatgg ggaagactgg acagggaatg 7320
gggcacccca aggccacagc cccctcctcc catgagaagg cacactccag gtctcacctg 7380
ggggtgggct ggggcagtcc tgccttgcct gggacaccat gtgtcaagag ccctgcacag 7440
gccaggcctc ggggcttgtg gaaggatgag tgtgtgtgtg tgtgtgtgtg tgcgcgcgtg 7500
tgtgtgtgtg tgcatgttca gatatatgga tggacagaca cacaaataag tgactgacca 7560
gtctgaggtc ctgcccactg ggtagggacc ccggaagtcc tcttggcagc tgtgcttcca 7620
ggagcttcgt tactgcctca ggctctgggc tcccagggaa gctcttggaa gggttcttgt 7680
ttcccttccc atccccttac ttggcccagc tcccttgaag ggtccaagac ctgggggcag 7740
caggtggagt gtgatcagca gggtcccatg tccagctctg gccagccctg cccaccccag 7800
gcccctctga gctccaagtg tctggctgtg ccccccaatt gggcacagct ctgaacctgg 7860
catttagaac ggttcctggg gagctgtgag gagggggtag ggcctgcatg aatagaagct 7920
tctggagcag aaggtgctac ttctgatcat tgattgacca tgatctccag accctgtcta 7980
actcaagcct gggcacgggg cttgggtgtc ttggtgcggg gacacaggac cattctccag 8040
ctgggctggt ggaagctttg gaaactgaat cgcccccctg cctcccaccc tggggagaag 8100
gaggcacctg ctgccagggc tgaggcttgg tggggtttcc cagctatttc gggcctcagg 8160
cactcttggt ttcaccaggc cagctgcact ggggtgaggg ttccagggcc ggtggggagc 8220
ccagcatggg cagggggctg gcctgaggct gtctggggct ggaacagccc aaggatgaaa 8280
acaaccaacg gcagagacaa acaaaacatc tattttccat ctgattgtcc ctccccccac 8340
ccagagagtc agtttccatt attatcaacc cagctgcaca gaggggaaac tgaggctgag 8400
ctcgagccac taactccagc cacaggggcc tggcgctagt cagggctcct cagtcgctgg 8460
ctgcctccag cccctgggac gtcgcccccc gtgagacccc agccaggtgc tccctacccc 8520
ccatcctctg ccctatttct ccccagcaca aatcccgcct cctacatgac attgttcctt 8580
gtctgttgac ttgatttccc tctcccgcaa acatgagctg tctgaacctg gctgtgcctg 8640
ccttaaccct gctgggtttc caggagcagc aggtcctcag aagagagctg aacatgtgac 8700
ttcgctctgg gcagcccctg agaagggggc ttacttacct ggccggtctg gggtctcacc 8760
ttcttcagct actctgccca gcagcccctg gggaccagca ccccttcctt ctgggagctg 8820
ctctctgctg cccagacctt tgcaaacttt ctgtcccctg tgggagccca ggccaagtct 8880
gaccaccact tcccatcctc ctccccagac aggtcaggag aggatgtgtc taggggtctg 8940
agtgggaggc tcccctttgg cctgaaactg tgaagatgag gcccctttct cctctatcat 9000
ttccatagtc agaaagtccc aacatgtccc tgcacaggct gggaactggg tgggcaggga 9060
gggcccatcc tagtgacacc tgtgaggggt ccaggctttg gtgcctggca cggcaactgg 9120
cacattggat gctcagtgaa catcagacct gatgtgagaa gcaggaggga cccgtggcca 9180
gatcaagggt gttggtgttg ctataggaag agagagtcac catgaaggat ggcctgtatg 9240
gaaagaggca cactgcgggt gccctggtgg gtcgtcctgg ctgtgggcta ctctttcctg 9300
gagctgacac gggggctctg tgttgccagc cacagaagtc acccagcccc tccctggctc 9360
ctgtcccaaa gccaggaggc attctccctg ctgcctgtgg tctccccagg aactagggct 9420
gcccagagga gctgtccctt gccggtctct ggacgtggtg tgctgttgct gagtgggaga 9480
tggtattagg gccacccctg gttgtgttgt gagctgggcc tgagtgagct catttctagg 9540
ggctccaggc aggggaccag gaatgtcatg gtgactgcct ggatgtggcc cctagtgagg 9600
ctctcctggc ccctggcccc cattgtaatg tccagcactg cttaccatag tgctaggtgg 9660
ctgggcttgg cttcctcccc ctcattatta gccattatga agaacgtcat tcagtcattt 9720
agcaaacagt tactctgagc ttgggcaacc aaaatttgtt gtttaaactg ggatgttcct 9780
gggagtggaa ggggcactat taataacttc acgagtctct ctgatagatg tgggtggggg 9840
tcctggaggc agcccaggcc tgggtctctg ggcagagccc accattactg ctacaatggg 9900
ccaggcacgg ccaggcctgg gtcccgagct gaggctgggt acacataggc acctgggaaa 9960
ctgcagctga ttggtggcca gtggtctggg gacctggatg gggctaaggg tcaccagggg 10020
ctggacactg ctctagcatc cacctcagct tccagagtca gtggcacaaa ctgggaatgt 10080
cctggaaaat gcaggatgca ggtcatcccc ctcccctcag accttgccca gcccacgtgt 10140
ttcctgggga gaccaccctt gtgaaattac tggccaaaca gggtcaggtt tgatgtggtc 10200
ccaagtgacc aagtgacaaa gactgaccct gatcctgacc ctactgcccc tgctgatgtc 10260
actgtgttga catttccgtg gcccatctgc aatcctcaag atgaccatgt aggagagcag 10320
tttccccaga tcaccccaga aagagggagt cctcacgctt gggttgttac aagaggtacg 10380
ggtgcctttt gaggtgtttg cataactaag cattttggga aaagacctag tcttcccggc 10440
ctccgttgat gccagctagg gatgcttctg aatccccgag ggaactggag catctcacgt 10500
gtggcgcagg ggatcctggg cagatttggg gtcatttttc cttcacgtct cattcagcac 10560
agggaagagg accagtgtca agtcatgaca cacgactctt tcagggccgt agaagctggt 10620
ccttaggtca gggatggagc ccagggtgtg gggtcaacat caaggactcg tgtcctgcag 10680
gcggggtggg tggggaatcc agaacctggc cctggtgtga cagagactct ggagaagagg 10740
atgacatgtc gggagggagg agcaacatcc tcagcattgt gctgtgtcat tagcagtggg 10800
cattgcgagt ggatggtgat tatttcctct atgtccccaa aattcgcatg ttctagttgg 10860
ctggaaactt gattttggac ctttgtgttg aggaatgggg gcttgcctgg gatctggtgg 10920
cctcgttatg gggcatctga gctggtttgc ttgttcccag gtgagtgtcg atgtccccct 10980
tcttgcccct ggattcagtg aatatggggg ttgaagggta atggtgcctt tgtccaggcc 11040
tggctgggga cactctcttg gtggctttgc aggccccaca ggaggctggg cctgatggga 11100
gagtcaccca ctcagttcat agtagctccc agtcctttcc tcccgcaggg ccctgagcag 11160
ccacccccct ctcctccagc agggcccctg caccccctcc caggctattc tgggctctgg 11220
ctttgctgta gaggaagcca cagggcccct ccctgatctg actcagaaca cctccctcag 11280
cccaggctgc agctaagcag ggccagggcc aggacgagtt cctctcaccc catcccccac 11340
tgtgacactc ttccctatac cttgaggggt tcccccagca cagaccaacc ctccttcggt 11400
gtcatgaggc catcactcgt gaggggctgg ccccggtctg agctagacac agtggcatgt 11460
gaagacaggc gtgggctaag gcccaactcg gctactcctg aactgggtgg agcctgggca 11520
gcgctggtgc atccatcatg gttcacgtcc cctctgtgag gtgggcaatg gcagctttag 11580
gcctcagggt cactgtgagg gtcagtgagg gactgtgatg ttcccactgt ggcccaagga 11640
tcacagctgg ggctctctca gatggttctt tcagttaaat cttttcctga gtgtggggag 11700
atgctcctgc tgccccagac actccctggg cagagtgcca accttggaga cttgacaggg 11760
tgggggcagt ggtgtctcca tgtcgttctc caagcttgtg agctcctcta gggcaggtgg 11820
tcctgggctg catacaccag cccctggccc acagctgaga gtttgttgaa tgaatgaatg 11880
agtgagtctg aacaaatgaa tggatgaatg aatgaatgaa aagcccttag ggccgaggag 11940
tcatgaaaag aggcgggcat gggtcagccg gtaacctact gtgtgaccct aggtgggtca 12000
tcacccctcc catcggagcc tcagtcctct catctgtgaa atgggcacat gaacacctgt 12060
cctggctctg ctttgtagac tcagagggca cccccatggc tgccctcctg cctgcctctt 12120
tcacccactg agtcaacaga gaatgaggag cccaggtctg cccatcccac agagccacaa 12180
gggggttcat gcactcagca ccatctcttg gccttgccca ggcacggcct caggatggaa 12240
gggtggccta ggtcaggggc ctgggcaacc actgtgctgc cctgaacacc tgcaggacct 12300
gggcaggctc agcctcctct gcacgcctta gggaaggggc tggctctggg ttgaccttgg 12360
atcagagtcc cagtgcccac catctgtgca gccctgggca gctgtgggac tcgggcaggc 12420
tgctggtctc cgaatctccg tctcctcatc tgtaaggtgt gcgggacatg gacacgtgcc 12480
tcctggggtg gtttgggatc ccatgacata gagaggacag acgccagtgc agggtttccc 12540
tggaagtggc cctgggccag gtggcaggtg aggtagcatc ttcagcagag ccgggagcag 12600
ttccactgtc gagcagtggc catcgagggg ctcagtgata cccagcccag cacctggctg 12660
aacatcggag gacgtgaggg gtgcagcccc tgcttccagg ctcccgtggt gtcccagatc 12720
ggtgctgggc agggcggcac caggagagcg tggtcagcag ccctgggcag ccatcaagcc 12780
tgaggcacca ctgggctgag ggctggggcc ggggaaggag caaggaaccc ttttacattc 12840
cggtagttca tgaatcacac agtgaaagaa agagtcacca agggtgctag ctgccggtgg 12900
ccctgatggg gcagcagcag aacaaagtgg gaggggacca tagaagagag gaccttggcg 12960
gggggtgggg gtgggggtgg gtgggtgagg ggcttcaaga tgacgagaat gatgtgagtt 13020
gccaagccca tcctgaggtc aacagaagga ggacagtgag gggaccattg gattgagcca 13080
cgtgcaggcc actggggctg tgatggggtg gtggtgagac tgctgggctt gaggcaggaa 13140
gggaggggac cgtggaggcc aggagccctt gattaccact tgtaaaaggc aggagagagg 13200
gaggggcagc cagaggaagg cagcattcac attttattac ttcttcctgg caggaccaca 13260
tttgtgctcc taaggtgacc atcaggaggg tctctggccc ttcatactga gatgttgagg 13320
cagagagact gtggtccagg ttctctccag gaagagccca ccattactgc tgcagtgggc 13380
caggcaggac taggtctggg tcccaagccc aggctgggca catatgggtg cttgggaaac 13440
catagttgat tggtggccag tggcctagta cctggatggg gccggggtca ccatgggctg 13500
gtcactgctc cagccccagc atcaacccca gctcccagag tcagtgggga aggggactgg 13560
agtggggtcc gattacagtg accacaggga aatgggggcc acagggaaat gggtgcgggg 13620
agcaggggag attcgggagg tgggtggaag aggaccacgt gctcccatcc tgacagccca 13680
gagcctgcgt gtgcctgggg cggctgctct ctcaaagggc atgcgtctgt cttggggact 13740
gagggtctct gaagtcaggt cgcctcttgc tcgaaagccc cctgccacct tgctcttgac 13800
tttagcacct cctcacaggg cagcacgtgt tatgttatcc gggaggaaat ggaaaccctg 13860
ggaggttctc tggtggggga agggaggagc ggaggtagac taagaggggg tcagcagggg 13920
gagaaggggg aaccagccca gagttctcca gggacgggtg cgtgttgtcc tagcctgtgc 13980
cctgggagtg acaccaggtg agttgagatt tcagtaccca gcatttttgt gactgaagta 14040
aagaaaattc tgatttggcc cttgcctgct tgtacaagtt aactgcttgc tttttgccca 14100
gcatcccttg ttcacacaat gtgatcataa gctgcagatg tcctgtttct ttgtcaagaa 14160
ggaggagata acttcagagt cacaaaagta ttttgcagga gtgaatgcct ttagggacgt 14220
agagaccagc cgctgtcgcc cgcaagtcta gttgcttaag atgttacctg agactgaata 14280
aacacagact tttcccctga aatgccacct ccctcactcc ttagccacat aaaaactccc 14340
tgcttcatcc ttttgttaac atggagtgga ggaatttgct ttcttgtctt cttactttag 14400
ccaaatgaaa taaatctttt tctatctcca agcacttgtg tcagtttttg acctccgctg 14460
catatcaggt acacgaacct gaatctgggg ttctacaaag agtctcacat gtcaccactc 14520
agcccccctc gaacacctac tgcgctcggt gctgggcccc gagaggaccg gggttcctct 14580
ttcccacagc cccagaccca gagccccatg tgctcttccc ttgggagagc agtccctgac 14640
tgaagatgtc aggaattttt ggatgttgag ggagcaactg ggaccaggaa tggaggggat 14700
tgggcttggg gagccacctg ccagggactg actctcctgg aggtggggga caccgtaagc 14760
cctggatcca gaaccaggac tgagatgggg tctctaggaa aaggggactc tcatggtccc 14820
tccctccgag tgccctgacc ctgatatttg acccggagga aggagaaggg gcatgaggaa 14880
tctggctact ccaacctgag gccccgtccc cttccatccc ttgttggtcc aataattctg 14940
tcacttgaat cccgggtccc gggatggggg cctgggtcca gtgggctttg agctctccag 15000
ggaggaagct ggatgaagtg ggtgggcgtg gccaggtggg ctgagggcag ccaggcacct 15060
ggggtccaga gctgagatct gcagttgggt ggaccaggtt tgagtcccta ctgtgacctg 15120
tggcaggtca ctcaggctct ctgggctgtg atgtcaccat cctagagtga ggatcacaat 15180
aggatcttcc tccaagggtg atttggcctg gagggcattt agtctcaggg ggcctgctgg 15240
aagacagtgc cctagagctg tggctaaact cccagtgcct tcctggaacc ccaggaggag 15300
aaggggccac aagagaccag ggatagggag ggcttgggct gggctgggac ggccccccag 15360
gagtggctca gcctggactg ggcagggcat ggagaaaggg agaggaactc gggaaagggg 15420
ctgtggtcgg ctaaattagg ccccgcgggg acagtcgtgt cccaatcctg gacctgtcta 15480
tgtgtcatgt gtggccacag ggactttgca gatgtcatgt caattaggag cctgaggtgg 15540
gaaatgctcc tgggttatcc aggtgggtcc aagctggggt ctttgtagaa gaaagaggga 15600
ggcaggaggg tcagagtgag aggacaagat gtggggatgg agggagacgg agagagagag 15660
aaggaagaga gggagagaag aaggtaggga gggagagaag agcaagagag agatttgaag 15720
atgctgagct caggctctga agttggagga aggggccagg agctgaggtt gtcctctaga 15780
agctggaaaa gtcctggaaa cgaattctcc ccagagtccc cagaaggagc cggccctgct 15840
gggaccctga ttttagcccc caaggactca ttttggactt ctgacctcca gacctgggag 15900
agagtcagtg tgtgatgttt taaggcacta aattaggggt catttgtgat aacagccagc 15960
agccacagga aagtcaaaca ggagccgtgg gagagactcc ccaggatgcc acaagggccc 16020
ctcccaggcc ccacccacag taacccaggc ctgacccctg caggtgcccc cactctacag 16080
aggaggggcc atgcaggagg ggctgggtgg ggctgggtcg tgttctcttc ccccacccct 16140
tcctctcaga gagcagttgg agccccagac tcagggaacc tcacagagaa agtcctgatg 16200
agggacctgg ttttccagtg aaggcccggg atccaatgga gaagtgttcc caaaaatgat 16260
gttcccaaag acggccagtg actttctgtt cacgcacttg agagaatcac catgtctaag 16320
ggctgccaga tagttacctg tgcgtgtgtc aaggttcaca tcccattact actgaggcct 16380
tggatagaac atgttcccac ttttagttgt gacgagatga ctggccccag cattgagaac 16440
accaccttcc cttcagcaaa gggtttgttt aaatttacag aagtggtgaa gtgcttatta 16500
ccctccttgc actggttcct agggagctca gagcctatct tttccaagtg tcccgagcct 16560
cctgtaggcc tttcgtgtga gtctccttcc tggcttcctc ccattcctct taagtgtctg 16620
aacctgctgt caggtgagga atcgaggtgg gtccctcatt gaacagcttg agaagtcagt 16680
ggtgctggag tgtcctggac agtctggctc tcagggatga cagggagggg gtgagggtgg 16740
gtgggagctg agctgggcac agagggagga gggcattccg ggggcaaggg ccaggggcaa 16800
agaggctcca ggcttggagc agggttttca ggctgggaaa agagatggtg ggtgaagggt 16860
gtctctgtta gggcagagat agagggtgta actggagtcc cagccagaga caactccatc 16920
caggcaggag gcagggaggt ggggggctat gctttgagga gaagggggag gaatgaaagg 16980
gcagagggac tggtgttcag tgatcagact tctcctatcc gggcctcttt caccaggaga 17040
caccccggga ggctatgagc ctctccctca gggccacttt ctcactgggt gccaggattc 17100
ccccacccaa cactgagaac ccaggggagg cctcaaatta tgtgtgagat aagaaaagaa 17160
gagagggagc aggatttctc gttgacgatg aggatattta ttgagaaggg ctggatgact 17220
tgggatgggg gcagagaccc ctcccctggg aacctgcagc tccaggcccc tgtgggtggg 17280
gtgagggtcg ggggcctaag agcattctgc aggggccact gtcttctcca cggtgctccc 17340
ttcatgcgtg acccggcagc tgtagcttct gtgggacttc cactgctcgg gcgtcaggct 17400
caggtagctg ctggccgcat acttgttgtt gctttgtttg gagggtttgg tggtctccac 17460
tcccaccttg acggggctgc catctgcctt ccaggccact gtcacggctc ccgggttgaa 17520
gtcacttacg agacacacca gtgtggcctt gttggcttga agctcctcag aggagggtgg 17580
gaacagagtg accgaggggg cagccttggg ctgacctgcg gggtggatga ggggcagggg 17640
gtcagagtcc tggtgtccac ctggggagcc cctgacctca gtcttgaagt gggtatggga 17700
ctaaggccca gggcagggac ctcaggccgg acccttgctg gactgaggtc aggtcagcgg 17760
tgagtggaga cacttgctgt cagatgggag ttgcccccac tcttgggggt cacagacccc 17820
ctcttggatc tgtctctttt tcatattttc catcacctat agacccccac cggtgctggc 17880
tccacactgg atgggatgga gtccaggacc acatctcacc ctgggtattt gtctatcttg 17940
ggggtgtctg tctgaacacc tcctaccagt tccccttgtt ctcatctctt catgcagggc 18000
agctgttggt cctgggttca ggctcttctc tctcacaggg agtgggtttc ttacccacac 18060
atctccctgg tgccatcatt gcagccccca ccccacctcc ctgcagagac ccctctgggc 18120
tgcctggtga gacagggtgt cagtcctggg ggctggattc cagtagatca aaggcctcca 18180
tttgaggcat ttttttttta ctccctgagc tgaacgtgga gctttgtctg ttcgaaagag 18240
tctccatgtc gtgagaagtt atctggggga tctgactctc cagtgggttt tccctgacaa 18300
acaggcaccc gtcccagtca ccgtccctac cagaagtccc tgtcctgggc atctgctctg 18360
aggtcttcct ccagtggagg aattggtaag catccacgtt tagggcctga gttttctgag 18420
acccaccacc ctgtctgtgg tgtcctgcct gtcttggggg atggcgtgtg acccagcgct 18480
gtggggccac cttctcacgg aatattcttc ctctatcttt gtcctcctgc catttcctcc 18540
cccatctctc caagtcctca gtcaaaggcc tcctgtcact gtgtttaatg cagccccgta 18600
actgggaccc acagaggaca gaatcacaga agagggcagg agcccaggca aggaggggca 18660
aagattccag acctccagac aggcttagac cttagccttc gacagacagg aaagggaaaa 18720
actccccgtg tttaacttgg gatctcaaag aggagagaag cggggagact taccgaggac 18780
ggtcagctgg gtgcctcctc cgaacacagc acacagtgac acagccccac acacaaaccc 18840
ctcctgacac acccgacccg ttccccgctg cagcagcttg ggcgcccagg tccagtggcc 18900
ctgtcatgaa gcaggtctgg ccgataggag ggtgaggggg atggcccctc catgcatgga 18960
tgcacacttt actggaagtc agggatccct tcacccccag agggagaggg gagagggagg 19020
aggcatgtct gcacatcaca tctgggtccc ctgctactct ctgtcctgga ggaagccatg 19080
tgtcccggct cagctccttt ggagactgtc accatggaag aagtgagaat cctgtttatg 19140
ccacagggaa ggtggagctg gtcccctatg gagatccgag ttccctggga gggtcctgga 19200
tgcccagcac agcccctagt gggatgccca tgtggtaatg attctaaata gcacaggaga 19260
gtgtgtgtgt atgtatttgc atgcaggcat gtttgtttgt gaatacctgt gtgcctatga 19320
ggtgttcatg tgtgtttatg tttgtgaaca tgtatgtatg tgtgtttgtc tcatagccca 19380
ggccccccat cctgtgctac ctcctgggac aatcatcaac ccggttctta gatcccacat 19440
acagctctta aaaagaccaa ttggtttaca ggcacgtcta tggcaccact ctggaatctc 19500
atgattgact ttgacctccc cagccccact gaccatccgt ggataactgg acattaggta 19560
cttgaggtgt ggtcagtttt gggctggtta cttaggggtg agagagagta gagttgaccc 19620
ttatccccca ggggacttga gtataactgg gacactggtg acacatgtgg gaccaggggt 19680
acccagctgg cctgtggggt gagtgacctg ggtccagagg gtcagggtcc agtctgtgcc 19740
tgcttcagag atagatgtgg gggtagaggg cagggtcctg ggagtcagga acagggtggg 19800
cccctaagga gtaggggaga ccaagggccc atggactgga gaggctcctt ccgcctcaga 19860
aggagggacc ccttgagaga gggaggctgt ccaggggtga ggcctgatga tccgtggagg 19920
gtactcgttc ttctgggcca tggggaacca aggagcggtc gccccaggcc gctggaggtg 19980
gacatgtcca cacaaacaca gcacgtatgg gaaaggggca gtcctggggc ctgctgccca 20040
aggctctgtt ctggaatatt ctctgggcct ttctaggtga tggtggaact acccctcaaa 20100
aacaatccag acttcattcc cacaaggcta aaagaatttt gttcatcttg caggttggac 20160
caatttaggg tagaaaatgt ataaacagaa gcaaaacaca aaacccaggg tttctggttg 20220
actgaggata tttattgagg gtttattgag tgtaggaaga agggctggat gacttgggat 20280
ggggagagag accccctccc ctgggaacct gcagctccag gcccctgtgg gtggggtgag 20340
ggtcgggggc ctaagagcat tctgcagggg ccactgtctt ctccacggtg ctcccttcat 20400
gcgtgacctg gcaactgtag cttctgtggg acttccactg ctcaggcgtc aggctcaggt 20460
agctagctgc tggccgcgta cttgttgttg ctctgtttgg agggtgtggt ggtctccact 20520
cccgtgttga cggggctgcc atctgccttc caggccactt tcacagctcc cgggtagaag 20580
tcactgatca ggcacaccag tgtggccttg ttggcttgaa gctcctcaga ggagggcggg 20640
aacagagtga ccgatggggc agccttgggc tgacctgcgg ggtggatgag gggcaggggg 20700
tcagagtcct ggtgtccacc tggggagccc ctggcctcag ttttcaggtg ggtgaaggac 20760
taaggcccag gatagggacc tcaggctggg cccttgctgt actgaggtca acttggcggt 20820
ggcggggatg cttacctcct gatgggaaac tcctcagcat ctgaggactg aggagaatca 20880
ggcctcttct gctccagcct cctctccaga ttctcccctc cttatcagcc agctctcacc 20940
tcacctatgc tccccgacgc tggctgggtt cagccctggg ccctcgtctt tccttggggg 21000
acgtctctgt ctgaacatcc cctgccaggt ccctcctctg ggtctgttca cgagggcatc 21060
tgtgtcctgt ttttaggttc tcctcccttt tgacaagtga atttcttcct cacatatccc 21120
ccagcaccat cattgcagtc tctgccccac tttcccacag aggccccttg gtggggaggg 21180
gatgtcagtc ctgggagccg ggtcctggga gtccaggaga tggagggctt gcatgtgagg 21240
tatattttct gttctgagcc tggcgctgtg tctgctctat ggggtctccc tgtcgttggg 21300
agatctggct gtcctaggac aaatgtctgt cctgacaggt ccctgtcacc tgcgcccacc 21360
aggagtgcct ccctcagcat ctgctttggg ggtctctctt tttgggtggg atggggaggc 21420
tctaaccttg gactgagtgt cctgagaacc accctgtcca tggcagcctg cctgtcccgg 21480
gggaggagga gggacccagc accctggcgc cacctcacag gacattcttc ctccatcctt 21540
gtcccccttc atttccccaa gtccccagtc aaaggcctcc cttcttggtg tttaaagcag 21600
ccccatagtt gggacccaga accctgggaa gctgaacttt ttccagcatc cttcccctgt 21660
cccatggccc tggtgcccca gcctgagccc ctgctctgct ggtctttggg gactggagac 21720
tctgtgcgag ggagcagaac atcccagagc ccaggggaga atgccccctg agtgacagcg 21780
gcaggttcag gcctgagcag ggagcattaa gaggtcactg ggatcttccc atcatgcccc 21840
accaggtgcc taagaaggga caggctggag gaatttgggg ccaggaaaaa aggcaatggt 21900
ggcagacccc agagagattg agacctctac cctagagaga acagaaagga cagaaaagtc 21960
tccccagatc tcaccctaga cccaaaagaa tagaaaaggg gactcaccga ggacggtcac 22020
cttggtgcca ctgccgaaca cattacactg tgatataacc ctgcacacaa accctcctga 22080
tacacccgac ccaggccacc cccccccaac cccctgcagc tgctcacaag gcccagggtc 22140
cagccccctt ttctcatggg tgggtgagcc ataggtgggg tgaagggggt caccttctac 22200
tgacctgaat atcacttcct tgggggctta ggggttcatc cacctcagtc atgggaaggg 22260
ttgacaggtc tgtgtgtgga attgtctccc aggtaattgc atttctgagg agttgggtgg 22320
cctggatcag ctggtgtcag gaatgccagg gaggaagggg aggtgagcgg ctgggtgacg 22380
ccactgacat ggtgcagctg ggacctcttt gagaagttgg gaatggtggg gagggtcctt 22440
gatgcccccc acatcctcag cactggaggt tatgatggga tgggcttgga atgggaattg 22500
ggggttgtgg gaagaatgac gttgaccaca gggacacaga ccccactgca aggtctgagc 22560
tccagcatcc ttggcccagc tgtcctgaag gagcagctca cagatcactg cccaagtccg 22620
cctcctgaac ccatggggac agcttcctac ctataggcca tgtgtgctgg attagagctg 22680
caatggccca gaggagagct tctcaaggga ggtcataggc ctcactggca gtgtggtttc 22740
ctccaggagc tctacgtgtg ggggatctct gctgtccact tcagctcccc cggcttacac 22800
acacacccac atgtgtgtgc tctgcagtcc cctacatgca cgggtgaccc acacagcctg 22860
tgctctggag tgtcaccggc acggggggca cccacagtgg atgggcatgt gcagtgtggg 22920
gcctggacac acacagcctg gacctgcatc ctggtctggg cccatcacct gaagagctca 22980
cacctgggac acactcctgg caccatgcag tccccaacag tattccccac agcaagcgcc 23040
tcccctgact gctgagatgt ggcctgctgc tccctgatca gaatcccgtc cacatcttct 23100
cctgtctccc tcttggcctg gacagaaaac cctgccccac cctcccatat ccaggggcga 23160
ccccctagtc ccaaagcctg gagacagcag gtctcagctt tgctttgctc atgtcctgac 23220
ctgggcctga ctgcagcccc ttctaccttc ctgatcctcc cagaaggatg cccagcatgg 23280
acatgtgtgt ttatgtgcat tgtgtgtgtg tacacgtgtg tgtgtattat agctcagatc 23340
ccatgctgag ttcttcagaa gaagaatcag cgtcacccaa gctcctggca taaccccaga 23400
atctgacttt gaactcacca gtcaattgac aacttgtgca cagcaggaca ttaggcattc 23460
ataatggtgt cagtgaggag cagagccgac ccttgtcccc taggaatgtt gaatacagct 23520
ggggcatccg gtgacacatg tgggatgaga ggcacccaga gggggatgtg gggtgagtga 23580
ccagggtcca gggggtaagc atcccatcag tgattattat agggagggcc tgtgggggct 23640
gagggcaggg tccctgggat gacgggaaca gagtgtgccc atggagaagg ggagatgctc 23700
taggctttga tgaggggaaa tacaggtggg gtgaccacat ggccttggag ggggatggac 23760
aaacaccttg agagagggat ggcatctgga cagtgagggc cgaggacaac aaagaaggga 23820
gctgagatgt tctcccgggg ccatagggat gtaaggaggg tgtgtccccg ggcagccaga 23880
ggtggacgtg ctcacagggc agcaggaagc acaacagaga cgtgggtaag aatgaagatg 23940
tctggttcct tctgaagact atttccttgt tctggaacat tctatgggga taaggtgatg 24000
gaaaaagtat ggctcagaga aacacgaaga tggtcccagg ctgcattgtc acaagtccaa 24060
aggattctgt tgatctttgg agataaaaaa atttaggatg gaaagtggat aaacaaaaat 24120
gagcagacag catgttttct gattgacaag gaggacattt attgagggtt tattgggtgt 24180
cggcagaagg actggatgac ttggggtggg agggaacacc tctgccctgg gatcctgcag 24240
ctccaggccc ctgtgggtgg ggtgagggtc gggggcctaa gaacattctg catgggccat 24300
tgtcttctcc atggtacttt ctttgtgcgt gacctggcag ctgtagcttc tgtgggactt 24360
ccactgctcg ggcgtcaggc tcaggtagct gctggccgca tagttgttgt tgctctgtgt 24420
ggagggtgtg gttgtctcta tgcccttggt gactagggtg ccattttcct tctatggctc 24480
ctgggtagaa gtcatttatg agacacacca gcatggcctt gttggcttgg agctcctcag 24540
aggagggcgg gaacagagtg accaaggggg tggccttgag cggacctgca gaatggatga 24600
ggggcaggag gtcagagtcc tggtgtccac ctggggagcc cctgacctca gtgcatgagg 24660
agtgttcagg ccccccagta ccagtgcagg acctctcaga tgtggtccac actgtctcag 24720
aagggtgtga catcatgttc ctaaaagaac tctgtcagtc agaaaacctc tgagcttggc 24780
ccctgcccat cgcctgtttg gaaatcttcc aaggacttgg gcttttgtat agacagtgga 24840
ccttcaattg cctggcgctg cctcaccctg tcatcctgac gtgatccggc tctggctgtg 24900
ttctctgagc tctgtgagcc tcttgttaga ttcactctgg aaacttttct cacctgacac 24960
agctgctctg ggttggggga gagtgggtct ctcacgtaag agctcttgtt tgtacccaca 25020
tccgtctctc ctggatcttc tgcagtggag tcagggcctt tgctcaccca agtcccactg 25080
tctgtctgtc ctgggctctt tgtctgtgga gtctgtgtta gagtctctct gtgtttaggg 25140
ccaatctaca gtttttctgc cttgggatat gcctgtcggt gaactcaggg gttcctgctt 25200
ctaggggtgc ctcccacaga gacccatcag ccacctccct gaatgccatg gcctttcgtg 25260
acacttcacc tggctccttc atgtccagag ccttcccgtc cctcctgaca gggcttcatg 25320
ggtcccaggc cagctcaggg ctctctccct gggagcccac agaaacctgg agaggcccct 25380
gcacctccta ccttgttccc agcctggatc cagagtccca cagtccaggg gactgggccc 25440
tgagactctg agttttcatt cccctatctt ggctctgagg gtttcaggtc cttctaaagt 25500
ccaccaggtg gtcactcctt cgagcccctt gttccctctc cctcatgaga tggggcctca 25560
gtttcccttg cacaaagttc gttagacaga agcccaggtg ggggaggaca gaactgagca 25620
agttttaggg aagcagcctg gctctggcag acagacagac agatgagtct cagtaggtca 25680
tccagtctag tgccctacat ctgaggtcag aggtgaaggg gtcttggtga cccactgagg 25740
taagggtcta aacagggagg ggagaggtcc ttgaccaggg cctaggctcc agagagaaag 25800
catcaccaca ggtcaacaca agatacagaa aagaacaaaa gcagcagaaa atttcccagt 25860
accttgggga gaccagggaa ggagggggaa aagactcatc taggacggtc agctcggtcc 25920
cctcaccaaa cacccagtgc tgtgacacag gctcatacaa aaaccctctc tggacgcctc 25980
tacccccaac ccccgctgca gctgtgatgg aggaagctga ggccacagcc cctggtggca 26040
tctgctcatg agggagttca cacggctgcc acactcaccc ccacagagag aaggggacag 26100
ctgacatcct gtgaccagca ggatccctag aaatcctggt tcctggagga cagtggattt 26160
ggttttccca ccaaccatca tgcagccatg gggatgagtt tattggaggg cactgtgtca 26220
ctaggagtga actcccatgg tcagggataa atggtctccc tggtggagct gactcgacac 26280
tgactgcttg gtgacgccct ggggtgatgc agagagtgcc ctctccctcc aggaagaagc 26340
tggttaccct agagtgcggt gtcttgggaa gcttcccatg aacctatctg tgactccagg 26400
agcctcagcc cagccttccc tgggcttgtc ctagttggga tgggcctggc cagtgaggcc 26460
tggctggtcc ccactggaaa tgccagcccc atcctccagg gtaaaatgga aggatctcct 26520
gcacccctca acctggtctc attttggtgg gtgaggtggg gtagtggctg ccactgcctt 26580
attcaaatgt gagggacata aaggagctcc cgagtgtggt ctccaaatat caccttctgc 26640
taagggaggt gaggtcagtg cgggatccca ggcctggggc aggaaaggga catgatgaga 26700
cagaacctct catcctccga gaaatcagga gccatggaag ctcctggggc aatgggagaa 26760
aatcagatgc cacctgagga ggcgcccagt gggtaaatgt ttatgttttg tagccgcatt 26820
gtcattgcaa ttcagtatat ctgcagtgga gcccacatgt cagatgtcct cacacgctag 26880
agctcactcc ggtactacat tgtgctgtgc gccctggagg atggctgggc accagatcat 26940
cagttatcaa agtggtgaac aaaagggaag aatgtacatt ttttcttctt cccaaagcat 27000
gaagcacact cctgagcgca cggtgcagct gctgtgccct cccttctgga agccctcatg 27060
agaaggaggt ggaccgaagt cttgaccatc tgccttcctt ctcatctgag gcgcgaagtt 27120
attgatcatc aaatgcagct aatgtcactg aaagaatgac aacacaacat gggtggcttt 27180
gctggaagta gccacgtgtc ctgggaagcg agtttgccaa tgtccagcct gaaccccctt 27240
gagcctcttg atgctagaac catttttcag gaaaagagag gttgagggaa gcactgggtt 27300
cctgctcagg gaggtggcgc ctgcatcccg actgtgggag gtcccgggac cagctctctg 27360
ctcctgcagc tcctgccttg ccagggaaag ctagagcaat ttgggagaca cctgcagatg 27420
gaatgggtct aaaaacacat tcaccaatga taacgtcaag tattaatcca catagaaatg 27480
aaattaaatc acaaatatgc aacagcacca caaagtcgac aaaaatagac acaatgatat 27540
tcacaagaca tttgataaga ctctcattaa ctatttttga tgtcaagaaa tccttgatat 27600
tctctccagt tgtgtgtgtg atgactagca tttgcttcac acccttgctt gaaggagtag 27660
tttagttatt ctgctgtggg tgggtccgca ttatctgaaa atggatgatg ctgcggactg 27720
gctgatggga accttggagt cattactatt cttctgtctc cctatttttg tgttcagaga 27780
tcttcatcat aaaaatgtac aacttataga gagggtgaag cttgggacag tgtctcccat 27840
gggcttgaat tttcatagct gtgaaatggg tcaaacagag gctgagggac tctgggcacc 27900
tgaaattcaa ttcagctcac ggctgtgatt tggggcaggg gtggctggga ctgagctcca 27960
aaggggcccc tctctttgtg tatcattgtg gaaaaagccc ccaggccttg cagctctgtt 28020
cctgtcctgg ctggccatcc agcagctgct gccatgtccc tgatgaacca gaaacagtgg 28080
gggtcccagc ccgggcacta tggattaacc gagcctgtca aggccttcaa gggaccaaat 28140
tgcccactgt cagggacccc gggatgaggg tgtctctgag tgaggctgcc ggtgcaccat 28200
ggtgcagggg gtgaggggac ggaacaacgt gagtgacaga gggagtgggg cctggtggga 28260
tgggggtgtt tggggcagtt gagatcccgt gaaagcctga ctttgcctat agatagcccc 28320
taggtcatgt tcaccctgtg ctgaccttgc gtgacccagc cttgactcta gtccagaatg 28380
agactctgac acagactctc cccgacaacc atgggatgcc cgttctgtgc ctgggatggt 28440
gtctttgctc atttgtctca gtccacagga gtcctcccct cacacgagct gaccatcaca 28500
ggctcagcca cacaccaagc acatactcac tccaccccag agcctgactt tagaattggg 28560
aacttcatgg ttgagatctc agccacgtgc tggttaactt tgaacctcac cctaagccca 28620
tctgatcata actgatcacc cgtgtgcccc agcctcaccc cactttccag agctagcgac 28680
gtgaacacca gtatcttgca gagcatccta gggctcacta agttggctgg gatggtgagc 28740
aggattctgg acttcctgtt tccctattgc aggacttgta agtgtcttta cttagccacc 28800
ctgtattgtg aaaatctgtg aaattcacct gtgagtttcc attcccagac ctttccacaa 28860
gttcctggtg atggcaccac catggacttc tcacccgata aactgggcac ctggattttc 28920
ctcatccttg cttagaattt aaggaggttg caaactaaat atgagataag aaatgaagac 28980
agacagcagg atttctggtt gacaatgagg atatttattg agggttactg ggtgcaggga 29040
gaagggctgg atgacttgga gtgggagggg agacacatgc cctgatcctg cagctctagg 29100
cccccgtggg taggtgaggg tcggggacct aagaacattc tgcaggggcc actgtcttct 29160
ccacagtgtt cctttcatgc gtgacctggc agctgtagag gttgtgggac ttccactgtc 29220
gggtgccagt cttaggtagc tgctggccgc atacttgttg ctctgtttgg agggtgtggt 29280
ggtctccaca ccctgggtga tggtgatgcc atctatcttc caggccactg tcatggctct 29340
cgggtagaag tcactcatga gacacaccag tgtggccttg tcttggagct ccctgcctct 29400
ggggtcagag gagatgaagg tgtctcagtg accagctgag gcatacaggg gtctgaatag 29460
ggaggagaga gatcagcctc ccaggaccga ggtcccaaag gaaaccctga ccacaggctg 29520
tggcaagtca cagacaaaga tcgaaatcag aataaaattg tcaccaactt ggcagggaaa 29580
gaaagggaag aagagactca tctaaaatga tcagctgggt tcctccacca aatacaaaat 29640
gcggtgacac aggttcatac aaaaactctt ccctggggcc cctaactccc cctccccatc 29700
ccccacctga agctatggtg caggaagcca gaccactgcc cctggaaggc atttgctcag 29760
cagagtccac acacctgcct gcccttctca agctgagatg ggacagtcga ccaagcgtat 29820
gcagtaacgg gacgtctgga aatggcgagg cctgaggagg ttggtgtctg gatcaggttt 29880
tccaggtgac tgtgacccag gaatgggaat gagctccttg agggcatttg cttcacgaag 29940
gagtgaagtg acatggaagg ggacagggat tctctatagg gttgttgtaa ccctgatctc 30000
ttggtgtgac tacagggtaa gagcaggagg cgtcctcagg tgtccccagt gagtgcctta 30060
gaggaggggc agcttgcccc agagtcagca gtcatgggaa gctccaacgt gaccacaacc 30120
acaactccag ggcgtctcac ttccgtcctc cttgtgttgt cttagtttgg gatgggtctc 30180
actaggtttt agtatgaaat gccagcctca acctccaggg agaagttgga agcaagcccc 30240
tgttaccctt tcagggtctt gtctcatttc tgggtatgtc tggagtgtct gactcaaaag 30300
ggctgtgtga gaagcacccc aagtgtggtc actaaatccc acctcccagt tatggggact 30360
agtccacttg gggttaatgg gcaattccag gcacaaggca ggagaaagat gtgcccagga 30420
tagattgtga acagagagcg gaaagccatc gaggtctcct gggttccttc aggaggatcc 30480
tggggccacc agaagaggca ctgagtgggc cacggtgggt cattgtcatc atcaatgaaa 30540
tagaaccatg gtggactcaa gtgagtcaca tacagtaaca taactttgag ctcaccatga 30600
aataattgtt catcttcacg agatggcagg caacatggtc atcattatta agatgctaaa 30660
tgaaaggaaa gactcaacat gtctatgcta tttcttactg aaataagaat cacactccca 30720
gaggagcaaa gaacatatga gggcacacct tttacagaca gtcagtagaa ggaaaaggtg 30780
gtcgaactga aatgcagtca ccttgcatcc atataccatc taatggcact ggatacaaag 30840
tgtgaagccc agctaacgtc acaaatagat gaccccacat gggagcccag tagccaagcg 30900
gtcttgctga aaagtcacac tgagccttgt taaacctttc tggccaagaa ccaattttca 30960
ggaaacgcag aagcagagag gagcgcttgt ttccagcttg gggaggccac aggctgtatc 31020
ctgaccatgg gaaggtcctg ggaccaaccc ccagctcctg tagctcctgc cttgcaagga 31080
aattaaaaat caatgaggaa gatacctgca gacagaacag gtctaaaaac acagtcacca 31140
gtcacaattt caaaccatat tgaatcctca tagaaatgaa atggaaaacc acagaataac 31200
aacaacacaa acacaggtct agtgaaagaa gcataggata tttgtgaagt atttgatggg 31260
aaacattctt tttttgatat gaaagaatta gatatttata tttaggtttg taagaatgta 31320
gttttttggg gggggtccat atttttagag acacaaatgg aatatttaga ctaatggaca 31380
tgatgtctac aatttgcttc aaacaactgt gtaaaagagg ttacttgatt gtgggtgggt 31440
caacatgagc tgtattatcc tgttttttta ttttcttgct gtcagtttcc gtaatatctt 31500
acaaggcagt aattagagag attagtcttg ggacagcacc aggggacatc cagaggggat 31560
cctacccagc agggccattg agaaggtgga gatcaaagcg gtcctctttg ctataggggt 31620
ctcagcgttc acatctatga aatggggcca gacagggtgg tgggaatcag gacccttaag 31680
tttccttcta acttgtaggt tgtgacttga ggcaggggtt ctatgattag gctccaagag 31740
gaaccccttc tctgccccac tatggcccta gagttctctg cccttgcagg ctctgtctca 31800
ggcctggcct ggccacccag cagctctggt gaaggcacct gccacaccgc tgatgtgctg 31860
gaggcaccaa gaaggggcct gacagtgccc aagactgatg aggagggctg ggaagtgcat 31920
ctcccaaggc cacctcactc gctgtcaggg accctgggat gattgtgtct ctgacatcag 31980
ggtgtaggtg cacatggagg ggctgaacca catgattgag ggagggagta ggccctggtg 32040
gggaggggtc taaggtagct gagtcccatg aaaacttgac ctgcctgtag cccttaagtc 32100
acacttaccc tgccctgacc tagtgtgacc tggccctgat tcttgggcga gtatgatttt 32160
gacacagcct ccatcagaca accaatggat gccgattcta tgcttgggat ggtgcctttc 32220
tcatttgacc 32230
<210> 73
<211> 115
<212> PRT
<213> Intelligent
<400> 73
Met Ala Trp Ile Pro Leu Phe Leu Gly Val Leu Ala Tyr Cys Thr Gly
1 5 10 15
Ser Val Ala Ser Tyr Glu Leu Thr Gln Pro Pro Ser Val Ser Val Ser
20 25 30
Pro Gly Gln Thr Ala Ser Ile Thr Cys Ser Gly Asp Lys Leu Gly Asp
35 40 45
Lys Tyr Ala Cys Trp Tyr Gln Gln Lys Pro Gly Gln Ser Pro Val Leu
50 55 60
Val Ile Tyr Gln Asp Ser Lys Arg Pro Ser Gly Ile Pro Glu Arg Phe
65 70 75 80
Ser Gly Ser Asn Ser Gly Asn Thr Ala Thr Leu Thr Ile Ser Gly Thr
85 90 95
Gln Ala Met Asp Glu Ala Asp Tyr Tyr Cys Gln Ala Trp Asp Ser Ser
100 105 110
Thr Ala His
115
<210> 74
<211> 32230
<212> DNA
<213> Intelligent people
<400> 74
gaattcctga cctcgtgatc cacccacttc agcctcccaa agtgctggga ttacaggcag 60
ccactatgcc cggctgtgaa catgaatttt taaactgcat ggtgctttgg gtcccagctt 120
ctccatctgt acaatgggga cagtactaag gttttctttt tcttctcagt tgactgaatt 180
atttccatag tctgtctgtc ttgccactct tgttacccac acgaaaggac ctaaggtaat 240
ttctgacagc ctgggactcc ttgtgcaaaa cagaaggtgc cacagacctc attttaggag 300
aaacctttgt tttcctcttg gaaccccaag aactgtaagc agacaggtcc atctcaaaat 360
ccaaggctct gctctgtttt gctttgcttt acctgacttt ttttttgatt tgggtgggca 420
tcaaaaatta gtaggggaga gctaaagaaa gttgtggata tgaacatgta tttatggtaa 480
ggtaagttat gaaggagaga aatcttagga tcttgtatgg caaattcttg cactaaagta 540
gataatgact aattaggaaa gcaggaaata taggacaagt cagaaagtca taagatggga 600
gagaaaagct tacgcctggt agatcctctc ctgtctagaa gtgtcgtatg tgtgatgttt 660
atatgaagga gctctaatta attggattaa aagataatga aagctctaaa attgtcagaa 720
aaatagaagc tctaatgcct tttatttcac gtgacttcag caatctttgg gaaatgagag 780
ttttaaaatt attggtggta aaaagtcttc aaaaagtaga catttggtct aaattaagtc 840
agaggttaaa ttggctaagt gctttaatgt cataaactgc ttctttgact ttggaaaatt 900
gttcagttta cctaatttgg aactgttaga tttctaggta aggcctgggg agaggtggag 960
ttagccatgt ctcctagcta tgctggaaga gttagacttt atctgcagtt ctgtcatgta 1020
tcctggactc tgcacctggt atgtaattga aactgcttac attgaaaaga aaaattatgt 1080
gtttttggtt ttaaaagggg tgggaatatg gttttttcca aaaagtgagt tttggcaaat 1140
ttagaaagtt taagaattat ttttagttgt aagaaaataa agtttaagca agttatagaa 1200
ggtttatgaa aattaacttt gtaaagaatt gtgtgtgtga gcaagttgac taaagggaca 1260
gtaatgttag atgtaataaa tgcaggtacc cttccacttt atcttctgtt tcttaggtta 1320
taaatattca ctacctacgt ttctaaaaac tctttcactg taatattaac acataactcc 1380
attctccttg tattgcctgc tttttcatag tatcctgaaa ttgcattagt agatttagat 1440
tcagaagatg gtggggaagc atcttatgag tgttttaagt aaatttaagg caaagggttt 1500
tctgtacatg ggtggttatc acagcatcac ttgttgcagc aaaacactgg gtaacaacaa 1560
tgtttatcaa tgagaaattg ttcggataaa tgatgatttg tgccttgcga ggctcaacta 1620
ttcaaaagca ccctcttttc ctcacttgct ttacctttgg ttctgggcct ggagcctttc 1680
agaggttact caggacagtg gactcctgtt tcctgtgact aatctggaca gcggcttcct 1740
atttcattct tcagcatctt ccaaaaattt ctgaagataa tttcttcctt tgtgaccacc 1800
catactcttg gtttactttg cagttaacaa tttcatgcct tcactggatt atctgtgtga 1860
aggtgtgggg tgtatgtgtt catactctgg agggagcaga ggaaaatagc cacagccaaa 1920
ggagtaatct tgcactaaat actcattata agaatgttga tacgttcata gatggtaaat 1980
ctgtcagtaa tttttacttg tatgattctt ggttaagact gcactcactg gtgataagcg 2040
tgctgaaggg atcataggtg ctatacttat gtgtgggaat tgcattcaaa ccaccaatgc 2100
ctgtctactc aagttttgtt gccttttgat taaaaactct tgggaatgtt tccctggcat 2160
gcaaatatgg gaactgcagt ttgattctag gtagaaactc tttggtagtt gaaatgccat 2220
aataagagac acagctgtca atgggcaaca attcactgtt ggtaaggaat ttacagtgct 2280
acttgccata ttcttcttta tccagacttt gtgccaagaa aatgaaattc tttttaaaaa 2340
tttttttcta gagtaatcct acaatattgc tgttatcaag cctgatgctg taattagtag 2400
aaaatgtcta gaaattaaaa gaaaagtagt attttccaac tatggttaaa ttaattgcaa 2460
aataacttcc tcttaattgt cagattggag acaagcttat taagagtgaa ataaaacata 2520
atgtgttgct ggtgctaggt acctctaaag cctttgagca ctttcttctt tataaaggct 2580
caatctactc atgtgtcctg taaataatcc tgctctacca gcatcctatg taaattttaa 2640
aaattatagt tcatatatta gattgtaaca aatgttgttc ttctttaatt atatgcaatg 2700
caatcttgtt atagactcac attagcttgc cttattccct gtatgtttgc tgtaaaatgt 2760
atagtccttt tcaatatatg atagcttaaa gatggactta atattttgtt ttagaaccaa 2820
aatcttttat cttatataca ggaaaattac attggaattc agagatcagc aaacatttcc 2880
tgtaaaggat gaaatagtaa ctattttcag gtttgctcag catgtggtct ctgacaacta 2940
aactctgaag tcataccaag gcagcatcag taatgtttaa atgagtgaat ggcgctgtgt 3000
tccaataaac tttatttaca gaaacaagtg gtgggccaca ttttgactgc agggtatagt 3060
ttgtggaccc ctgaacaatg gctttttctg aaacaacaca attgaattga gatttgaaag 3120
aatgttgagg cagcattgtt tgtctggggt aatacctgag gtttgtcatc tcacaccagg 3180
gaaatcaggg atgtggacac acaagaagtg agttcaagag tggatgatta ataggtgaaa 3240
gaaagagaaa agagaacagc tctctctcct gcagaaagag agaggggcac ctgagtgggt 3300
cttccggttt tgtggtgaaa agcacaaggt tttataaagg agcttgagga ggtggtgtct 3360
tgatttacac agggctctag agactggttg gaccaggtgt gaacgtttgc atagcacagg 3420
gagaagctgg ccattgcacc ctaatctttt attatgcaga tgggttcttt accttaccag 3480
gaccatattg tctgttcctt actgtacctg tggttgacag agaaaaggga agatggagcc 3540
accatgttga acatgcctgg cccacaggta gccttttcct attggcacag ctgctggcat 3600
tcctatgaga gcttatcaat gtctgcagcc caattttaca agatgctctt tgttagaaaa 3660
taaatgatat gggttttttt tttcattagt aggaaaactt tacactagga cttccttact 3720
ttcagtatct gcctaaataa tttcttttta attcctacat caatgttgca tgtgcaatag 3780
agaaggtgac atgtagggag ctgtgtcagc aggggttgca tatttcttga tgagcatccc 3840
atgatgcatt cttcttcact tgtggcaaca ttagcattaa ctaatctaca gtaaagtaga 3900
tgggtccaca ggtcatggga catacactag ctctgccaat tacatgttga tttaaataat 3960
atcattctct aaggacagct ttttttcccc cagatcctgg tatgtatgtg gagttgggga 4020
gagacaccaa actgtacccc atttcctcat acattgctta tacttttaga agtgtttgaa 4080
agataatatc acatactagt agtttactgt ttcttattca agttagtttt aatagtcgct 4140
agggtgaatg ttttcaaaat tgtatagata ttcgggttga ggcaatacta taaattatga 4200
gttcatctca gtttttttgt gctagcgtaa tgacatttcg gagacataat gcatatgtgc 4260
aaaatacttc acctctctgg aaaacagtaa agggctacat aataggacag acaaaaataa 4320
aggcttggcg taatggctca cacctatgat cccagcactt tgggaggaca aggcgggtgg 4380
attgcttgag ctcaacagtt caagaccagc atgggcaaca tggcgaaacc catgtttaca 4440
aaaacgataa aaataagccg ggcgtggtgg catgtgtttg cagtctgaga tacttggggg 4500
actgaggcag gagaatcgct tgagcctggg aggtcaaggg tatagtgagc cgagatcgtg 4560
ccactgcact ccatccagcc tggataacag agtgagaccc tgtctcaaaa taagtaaaaa 4620
tttataaaac aaagaatgtt tctaactgta ataaaggaga agtgatcaag cttaagtgta 4680
gcttagattt aatctttgat ttccgggtac tatattactt aaaaatatga tttggatatt 4740
tagaagttgt tcaaattaga aactcaggag tggggtcact ggtcactaag gtgctgaata 4800
tttttaatac cttagtggat atgtaatcaa caaagccaac ggaaccaata gagcatttgc 4860
tttcataaga atttaagtgt tgctgggtac tcttaaatcg agctcacatt attggtgtca 4920
tttaatataa ttactgaatt tctttgaacc cagtttccac tttttaaaaa ttatttagct 4980
cattaggctg aaaacttctc tttgttacat tttattacac ttcagtgtaa tatgtgtaag 5040
atgtacattg cttctctcta gaaaggtgag acaagttgaa gcagggttgg gggtgggtgc 5100
ttccagttca taggtaaata ggagacaaac ggttgcattc ttttgagttt ctgattatcc 5160
tttcactgaa tacacaattt acatgcaaga tgccatagag gaatagtcac ttatgcctga 5220
gtctggctta gtgaatctgc atttttacat aaaaaactgg gcagagaaag ccaatcagat 5280
acacatttgt ctcaggtgag gagagggatg actttgggtt ctgtcctttg tcccccacct 5340
gtaaagataa tctatcaatt gccaatttat attgccaggg tcaaattcaa cagaactgtt 5400
ttagtgtaaa gatcttgagg cccacaagaa atttcctttc tgacaaatta tgagggaggt 5460
atatagcttt cgaaatcttt gtagttattt ttttatttta ttatttgggt tttttttttc 5520
tttattgaca aataattgta tatactcaca gggacatagt gatgtttcaa tacagaaaag 5580
ttatagtgag cagagcagga taatttcata tcctttgtta aaggaaaata aatctccggg 5640
acaccccact aagccaaata atagttatct tatttagaaa taaaatggga ggcaggtttg 5700
tttgatggag ttcctagctg aggtgggaga attgcttgaa cctgggaggc cgaggttgca 5760
gtgagccgag atcgcgccat tgcactccag cctgggcaac aagagcgaaa ctctgtctca 5820
aacaaacaaa gactatagaa aagctatttg tgaaaatgct ttttgatgtg ctgttttatg 5880
tcacagaatg caacctgtgt tttgattcag caagttcaaa acactctttt tgtggaatct 5940
aagaattgat tattttgatc ctattgagct ttcataagaa aatatgaata tccagttgta 6000
aaaactagaa ataagctata agctatctgt ggaatgcttt gtgaggtgct gttttatatc 6060
ataaaattga acttgtgttt tgattgaaca agttgaaatt actcattttg tagaatctaa 6120
gaagtaacgt tttggaactt cttgagccct tattaaaaaa tagaaatatt cagtcctaaa 6180
aactagaaac aagccatccg tgcaaatgca ttgtgatgtt ctgttttgta tcataaagtt 6240
gaacctgtgt gttgattaaa caggttctga acactttttt ttgtagaatt tatgaagtgg 6300
catttctgag cctattgagc ccttatacaa acatacagtt ttaaaagcta gaaacaagct 6360
atctgtcaaa atgctttggg atgtgctatt ttatgtcacg gaatgaaacc tgtgttttaa 6420
ttcaataggt tcaacacatt cttttggtag aatctgagaa gtgacattcc caaacctctg 6480
aggcctttaa aagaaaatac gaatattttc ctctaaaaac tagaaacaag caatgcgtgg 6540
aaacgctttc tgatctgtta gtgtcacaga ttggaaactt tgttttgatt gagcaagttc 6600
aacgcactct ttgtaggatc taagtagtga catttccaaa cctattgagc ccttataaga 6660
aaatatgaat atttagtcct aacatgctat ctgtgaaaat gctttttttt tttttttttg 6720
gcacagagtc ttgctgtgtt gccaagctgg agtgcagtgg tgtgatctcg gctcactgca 6780
acttctgcct cctgggttca agcaagtctc ctacgttagc ctccctagca gctgggacta 6840
caggcgtgca ccaccacgcc cagctaattt ttgtattttt agtagagatg tggtttcacc 6900
atgttggcca ggatggtctt gatctgttga cctcgtgatc cgcctgcctc agcctcccaa 6960
agtgctggga ttacagacgt gagccaccat gcctgactga aaatactttt tgctatgctg 7020
tttcataaca cagaattaaa cctgtgtttt tgtgagacag gttccaaaca ctctttttgt 7080
agaatctaaa aaagtgatgt atccaaacct tttgagccat aataagaaaa catgaatatt 7140
tagccctaac tgctggaaac aagctatctg tcaacacact ttgtgatgtg atgctttata 7200
tcacagaaat gaacttatgt tttgatgaaa cagattcaaa acactattgt agaatcttaa 7260
gaagtgacat ttctgagcct attgtgacct tataggaaca tacaaacatc cagtcctaaa 7320
gtctacaaac aagctatctt ggaaaacact ttttgacgtg cagttttata acacagaatt 7380
gaacctgcat tttgataaaa acacgttccc aactctcttt ttgtagaatc taagaagtga 7440
catttcgaat ctattgagca tttacagtaa cgtatgaata tcttgtaata aaaactagaa 7500
acaagctatc tgtaaaaaca ctttgtgatg tgctatttta tgtcacagaa tggaacctgt 7560
gttttgtttc agcaagttct gaactctttg tagaatctaa gaagtgacgt ttttgacctt 7620
attgagccct tataagaaaa tacaaatatc cagctataaa aactagaaac aagctatcag 7680
cgaaaacact ttttgctgtt tcatatcaca aaattgaacc tgtatactga ttaaacagtt 7740
tccaaacact ttttttgtag actcttaaga agtgatgttt ctaaggcagt gaggccttat 7800
gggaacatat acataatcca gtcctaaaaa ctagaaacaa gctatctgtg ataaccattt 7860
gtgatatgct gttttatgtc agagaatggt acctgtgttt tgattcaaca actgtgagac 7920
actctttttg tataatctaa gaagtgatgt caccaaacct attgagtttt ataaaaaata 7980
tgaataaccc taaaaacgag aaacaagcta tctgtcgaaa atgctttgtg atgtattttt 8040
ttatatcaaa taatggaacc agagttttga tgaaacagct tccaaacact ctttctgtag 8100
aatctaagaa gtgacatttc caagtcaatt gagttcttac aaaaaaaatg caaaatccag 8160
tcccaaaaaa ctagaaacaa gctacctgta aaaatgcttt gggacatgca gttttatgtc 8220
acagaacggt tcctgtgttg attcaacaag ttcaaaacac tcttgatgta gaatctaaga 8280
agtgctgttt ccaaacctat tgaactttta ttaaaaaagt aaaaatatcc atccccaaaa 8340
actagaaaca agttatctct gaagatgctt tgtgacgtga tgttttatgt cacaaaatgg 8400
aaactacgtt ttgatttagc aagttctaaa cactttttct agaatataaa aagtgacatt 8460
tctgagctta ttgagctctt agacgaacat acaagtatcc actcctaaaa atgagaagaa 8520
aaacctatct ctgaaaatgc aatgttatgt gctattttac atcacagaat gaattttcaa 8580
acactctttc tgtagaatct aagaagtgaa atttccaaac ctgttaagcc cttataggaa 8640
catatggata ttcagtctta aaaactagaa acaagctata tgtgaaaatg cattgtgaag 8700
tgctgtttta tgtcacagac tggtccctgt gttttgattc accaaagttg aaacactctt 8760
ttggtagaat gtaagaagtg atgtttccaa acctattgag cttctataag aaaatatgaa 8820
tatccagccc taaaaactag aaataagata tctgtgaaaa cactttgtga tgtgctgttt 8880
tatgtcacag aatggaacct gtgttttgag ttgacaagtt ccaaacactc tttttgtaga 8940
atctaacaaa gtgacatttc caatcttact gagcccttat aggaagatgt gaatatccag 9000
tcctaaaaat gagaaaaaaa gctatgaaat tgcattgtga catgttgctt tatgtcacaa 9060
aatggaatct ttgtttttat tcaacacttt caaaactttt tgtagaatgt aagaagtgac 9120
attttcaaac ctattgagcc cttataagaa aatgcaaata tttagtcata aatattagaa 9180
gctctctgtg aaaatgcttt gtgatgtgct gttttatatc acagaattga acctgcattt 9240
tgatgaaaca gcttccactc acttttttat acaatctaaa aggtgacatt tcctagcctc 9300
ttgagccctt attggagcat atggatatcc tgtcttaaga actagaaaca agctagctga 9360
gaacatgctt tatgacatgc tgttttatgt aacagaatgg aacctgtgtt tttagtcaac 9420
aagttccaga cactcttttt gtagaatctt aggaagtgac attttctatt tttattgagc 9480
ccttataata aaatattaat atttagtcct aaatattagg aaaaaaccta cctgtgaaaa 9540
cgctttgtga tgtggtttca tatcacagaa ttgaacctgt gttttgacaa agcaactttc 9600
aaacactgta gaatctaaga agtgacatta ctgagcctat tgagctttta taggaacata 9660
caaatatcca gttccaaaaa ctagaaacaa gctcttggtg aaaacgcttt gtgacatgct 9720
gttttatgtc ataaaaatgg aacctgcctt ttgatgaaac agcttccaaa caggtttttt 9780
tttagaatct aatagttgac atttctggcc ctattgagcc cttatagaaa catatgaata 9840
tccagttcta aaaactagaa gcaagccatc tgtgaaaatg ctttgtgatg tgctgctttt 9900
tgtcacggaa taatacatat gttttgattc aacaagttca agacactctg tagaatctaa 9960
aaagtgaagt ttttgaacct attgagactt gattaaaaaa tacgaatatt cagccctaaa 10020
agctagaagc aagcaatctg tgaaaacact ttgtggtatg ctgttgtatg ttatggaatg 10080
gaacctgcat tttgatgaaa cagcttccaa aacacttttt tgtagaatct aagaagtgac 10140
attttggagc ctattgaacc cttacaggaa aatacgaata tccaatccta aaaactacaa 10200
acaagctatc tggtaaaacg ctttctgata tgctgtttta tgtctcagaa tggtactggg 10260
gtttcaattc agcaagtttg aaactttctt tttatggaat ctaaaaagtg acatttgaga 10320
acctattgag ccgttataaa aaattcaaat attagccata aaaattagaa acaagctagc 10380
tgtgaaaacg ctttgtggtg tgctgtttta tgtcaaagaa taatacctgt gttttgattt 10440
ggcaagttca aagcactttt ttttctagaa cctacgtagt gacatttaca aatctgttga 10500
tcttttataa gaaaatatga atatccagcc acaaaaacta ggaaaaatct gtgaaaatac 10560
tttgttattt gcattttatg tcacagaatg aaacctgtgt tttgatgaaa caacttccaa 10620
accctctttt tgtaaaatct aacagtgaca cttatgagcc tatggagccc ttatagaagc 10680
actcaaatac ccagttttaa aactggaaac tgtctcaaaa acactttgtg aggtgctttt 10740
ttatgtcaca gaatgaaacg tgtgttttga gttgaacaac acacaagttt ccaacactct 10800
tgaatctaag aagtgacatt ttcaaacttg agcccttata gaaacataca aatatccagt 10860
cctaaaaaca agcaaaggct atctgtgaaa atgctttgtg atatgctgct ttgtgtcatg 10920
gaatggaatc tgtgttttga ttcaagtttg aaacactctg tagaatctaa caagtgatgt 10980
tttgaaccta ttgagtcatt ataagaaaat gcaaatattt agccataaaa atgagaaaca 11040
agctttttgt gaaaatcctt tgtgatgtgt tttctatcac agaattgaac ctttgttttg 11100
ttgaaatagt ttctaaacat acttattgca gaatctatga agttatattt ctgagcattt 11160
gagcccttat aggtacacat gaatatcaga ttctaaaaac tagaaaggag ctatctttga 11220
aaactatttg tgatgtgctg ttttatgtca caaaatgata accatgtttt gattcaaaaa 11280
gtttgaaaca ctctgtagaa tctaagaagt gacatttctg agcctattga gcccttagta 11340
aaaaaacaaa caaaaaacga atatccactc ctaaaaacca gaaaaaagct atctggtaaa 11400
atgctttgtg ttgtgctgtt tcatgtgaca gaatggtgcc tgtgttttga ttaaacaagt 11460
ttgaaacact ttttttttgt agaatataag tagtgatgtt ttagaatgaa ttgagccctt 11520
ataagaaaat gcaaatattt aaccataaaa ataagaaaca aacaacctgt gaaatcactt 11580
tgtgatatcc tttttttatg tcacagaatg gtacctgtgt tttgatttaa caaatttgaa 11640
acacactttt tgtagaatct gagatgtgac atttacaaac caatcttaag ccagttagat 11700
actctgatga gccagctgtg tgtgtatgtg tgtatgtgtg tgtgatcttt gattattaaa 11760
actgaaaaaa taatcgtata ttcatgacta gtagacacag tgttttaaaa ctgattctga 11820
aagatttgag ggttaggctt gttttaaaaa caattgcata ggtcctggaa acaccaagaa 11880
ttagtggctt ctcattccta gtcacatgaa aaatatttta ctactcttgt gaatggccat 11940
aaataatatg cagaattttt tctgtgtcct aaccttttat ataattggtt ctacagtgta 12000
catcactgtg tgcaactttg ttttgtgtgc tcagacttac attttccagt tttctccact 12060
ttgatacaat tggtctgtgt ttcatacatt ttgtattttc tatagcgttc ctttatatga 12120
ctctaccaca ttttattgag tctcctcatg ctgacaggta agtagatgaa ttaataaatg 12180
aatgaataaa taaaaatgag agcaaatttc aaacaggtga ttaatttagt gattgtaacc 12240
atggactcag caggttagaa ataaaaactg aaagatttag aatgcaagca ggcacatcat 12300
accttctaat agccattgga actatgaccc acaaaccatt agcctagaat gatgggacat 12360
atcttgtctc taaaaaaagg tcactgttca gttctcaaag aatggatata aaaatggcag 12420
ataccattcc acattattct acttccttta acctctacgc ataaaacttg agctgcaggg 12480
aatgttacct cctgttctta aaaagacttg tagttcagtg aggaactcac tcctttcttc 12540
attcatgtgt tcaaataata tagggaaatg aatggaaaag tgaagagaag ttgaagacta 12600
ttatggggat agcacaggat tagtcagcct catggtatta ttgatctgcc ttattccaca 12660
aatatttacc aagcacctgc tacatgcaat ttgtatacta ggtgctgggg atacaggaga 12720
taacaaagtc cctgctgtca atgaaagggg tcagtccttt gattcatctt tagttaattt 12780
taagcacaca acaactatct caaactttct tcacactttc caagctcccg atccttcatg 12840
cactcttggt agatgcctga ccttacctct taccttacta gaacctaaga ccacctggta 12900
taaaatccct taagcacact cagatttgcg tgattttaca atgatgtctg ttcccaaagc 12960
atcctcactt ctcttggagc tgagggtgaa gagctcctct ttcttcccat ccgtgatctt 13020
ggaacatgta cgactacact tgtgacagta aatgcttaat acaggcagaa ggtttgttcc 13080
ttatttcctc cctggggcct ccctccagtg aatatctctt ctagcattgt cagttgtatc 13140
caacagaaaa gcagagatct ctccattggt ccaaaaacct aagatggact ctcactgcta 13200
aacttctcaa atgaaaattc ctccacttta gtcctgatta ccactcaaac actgttagac 13260
tgggcaggtc actacccctg cctagttctg tttccccatc tacataacag agaaataatt 13320
gcgccttatc tatcctacag aagtgtgaag aggtttgatg tgacagcagt gaaagcaatt 13380
taaaaagcac agagtgctat acataagaag acattttcat aattattccg ctctaacatg 13440
atatctgtat tcatacgatc tcaaagtact tacccaagca tggattctaa ctcttgtgta 13500
tgtaagcaaa ggtgtaagtc tgtcaccctc catgcaaata gaatctcccc tcccttggcc 13560
cctgcatctc accatataca ggaattaact caagatgaat caaagtttta aatgcaagac 13620
cgcaaactat gaaaatcctt taagataacc taggccatac ccttcttgac aaaggctttg 13680
gcaaagcatg tgtatgtcta agtccctaaa agcaatagaa ataaaaacaa ttattgacaa 13740
gtgagaccta atacatgaaa gagtggctgc acagtagaag atattaccaa cagagtaaac 13800
agacagcctt cacaatggaa gcaaatgttc ccaaactaca tctgacaaag gtctaatatg 13860
tacgatctac cttaagtcct taaatcagat caaaaagtcc aattaatggt tagagacatg 13920
aatacacact gctgaaaaga tgtaacagcc accagtaaac atgaaaacat gctcaacctc 13980
gttaatagag aaatgcaaat caaaagcaca ctggtcaaaa tggtgattat aacacagtcc 14040
acaagaacag ataccagcag gacagaggag ggcactgggg caattgatca tgattcttat 14100
ggatagtcat ttagtgttat taatgaattt cataacaaaa tgatcaccat acaaaaaata 14160
caaaatgtgt tttcttccct gagaaaggaa aataaaaact tggaatgccg attcactatg 14220
ccaaaaggaa aagttaagct gaaagctgag tcatgcaaga aactgccttt cttttttttt 14280
cctgagcaga cagctactga taaatagtta aatttctcca caggtagcta ctctatgttc 14340
atctcatctt acttaaagtg ctgatttact gagcaggaga aaaatatata actgactatt 14400
cctttacctg tttgttttct cttgcaacat gtggattcag caacgtgacc atactctccc 14460
tcttttcccc gcagcctgct tttctcttct aaacactgaa accctaaaat atttttggag 14520
aaaggcacag acctctgtcg cccagccatg tctttaacct tggaagaaga aacttctaaa 14580
ttgataagag atctgtctca gacacttttt cgtttacatc ccgttatctc agaaagcaaa 14640
acaggctttg ttccaaccca aagtaatttg tgaatattca agcggtatca ttctgatgta 14700
aaatttacat aaattcttgg gtttaccaaa atgcaaatgg gcaagcagat cactatttac 14760
agataatggc ctaaaaaatg gtaagagtaa atgctgtgga gctaaatgtt tctgagtctg 14820
ccatttccta gttttgtagt ttctctcggg caagttaccc aaagttgctg tatgttatta 14880
tcttgacatt taaaatagaa gtaataactt tattataaat aatagttaat accatagggt 14940
cattaggaaa gtgtctggca tatatagtca caacccagtg aatgccatta ttgtttttgc 15000
tattatcagt ataataattg atactaattt tgatgctgag gtaaaataat atctggcagc 15060
ttttaatttg ctaatgttaa ataactgaaa atagctttaa aaagtgaaaa tatccaaatc 15120
aatgacaata tttgatttat ataaaataag cttcattttt tttagttttt ttgctcctaa 15180
ttattacttc actcatcaca ctgatatctg agcacttttt aaaacatatc cacccttctc 15240
agttgtacta cttattccct tttcttgtaa tcccagcctt caaagatcct ttctcatttt 15300
tctaactcat ttcacgactc cctcaccttg acccccagtt atatctctct tgaagtcaat 15360
tccattgaat tgactacttg gcccaaactt caccccaact cagtctctct tcaggaagga 15420
aagtccccac acaaaaagga atgtgtcttt caactcatgc gccctttttg aagaagcttt 15480
ccagacagct tccttacagt gatctccgtt atccatcctt tagatcgctg tggagtccta 15540
caggggcgca atgtggacag tcattcaaat gaagcacacc taagtgcttg cattttctaa 15600
aggcccattg attcatgtaa ctcccgtact tgcacagata agatgttcct gcctgaatgc 15660
agcagatgga aatgaaaatt gtattctctg tcaaggctga ttgtattaca gcttaatgat 15720
ttgcatttta aaacttggaa gttctcataa atattaaagt gaaagaacaa ttggctacat 15780
tattaggtag gttcggctgt tcgtataacc tggtgctaac tatctaacct gcctgagtga 15840
gcctcagtct tcattactgc agcatttgta agatatcaat gcctgcttga actcatgtct 15900
tactaagatt atggccagga ttgagtaaca tatggatata aaagcacttg acaaatcaga 15960
gtatttcata aatgtaataa taatatgcta catttataac atctatactc ttttcctgtg 16020
tctatcttca tttaaacctt gcagtttcta tcataatcaa agattttgta atcaggttac 16080
aatgagtagg atttaaccca taagcaattt tcaaatttcc tagatatgtt ttcagttttc 16140
acatttatgt tggtgacaaa attctgtttt cagttttggt gtttgcatct tctaaaacag 16200
tgtcttgggt acttgctctt tgatgagaca ctgtgcagac ataaagagtg taagaaaaca 16260
gaacagttta tctcagcttt ttgtggtcta gataacctgc acactgcttt cttggctcac 16320
tgcaacctcc tcttcctggg ttcaagtgat tctcctgcct tggcctcccg agtagctgag 16380
actacaggca tgtgccacca cgcccagcta atttttgtat ttttagtaga gatggggttt 16440
caccatgttg gcccggatgg tctcgatctc ttgaccttgt gatccccctg ccttggcctc 16500
ccaaagtgct gggattacag gtgtgagcca ccgtgcccgg cctgcacact gctttttaat 16560
aagctgatct gtcttcttgt ttacataggc tgtgctatag tcatttaaag ttcaaaatta 16620
ctgctaaaaa gtaattaatc ctttactgaa atattcctgc tatttcatga gctgtcttac 16680
aatttggagg aatctatttg tcactgatgt ttaaaaaaga aagtcacagc agggaggctt 16740
tagcttcatt gaggaacatt attataaaat aaaatgatcg agggtaattt ttttttgtcc 16800
ttgtggtact gtttctgcag atctacatta atctgagcat ttaaagtaat aataaatttg 16860
ttatatcctc tttattattc acttcaccat ggtagcccct agtggtaaaa ggagatgtaa 16920
attgctcagt gctcacattg cagggaattt tttcctcagt tgaataaaaa ggagttaagc 16980
ctctttggaa atgagggcta tagcctgtca ataactacat atattcctgt ttttaagaaa 17040
tcagaattct ggtgtccagt aaatgtagat gccagcatta ttaaaaagtg attgagcaga 17100
gaaatgaatt gaatttttga cccactctgg cttccagctt tcatgggagc ctatacaggg 17160
ggatgatgaa gagggatata agagaataaa tgattgctct attaatctac tttaattgat 17220
actaaaatct gacagcgaat tacaagttcc aggcagtaag gcttaccaat tcattggtaa 17280
tttcaaggtt ctactttgct ttctttttgc cttcagctcc ttgcaaagga cacctttttt 17340
tttttttttt tttttgagat ggagtattgc tcttgttgcc caaattggag tgtaatggcc 17400
cttaacatcc gcctcctggg ttcaaatgat tctcctgcct cagcctccta agaagctggg 17460
attacaggca tacatcacca cgcctggcta attttgtatt tttagtagag atggggtttc 17520
tctatgttgg tcaggctggt cttgaactcc tgaccccagg tgatttgcct gcctcagcat 17580
cccccgccca aagtgctggg attacaggta ggagccacca cacctggcca aggacagcct 17640
tttatagttc agtttctcag tttatctttg actattctta attaagcttg acctggttct 17700
ccaccactga cgctattgga gttgcaaagc attttgctgt tataatgata gctcccttga 17760
tggctgttca ttattaactg gttttcaaaa gtgctgcttt taactttcat tttataaata 17820
tttaactcaa tttttataaa atgtgcatag actatagagg ttctgcttac ctgtttaata 17880
cagtaaaaaa atcccttttg taatcttata taatattaag aatgtgtcct taattcatgc 17940
ttaacataaa ttcttacaca actagcagta tctcaaaaaa taaatgattt aatagtttat 18000
gacccttata catataatta attgtagtaa aatatcttag aaaatagaat gagtattttt 18060
tataaagata aaaaatcctg attttttttt ctggtcttaa tataaaatta aatgtgttaa 18120
agggaactta taaattacat agtagttcat tgctcaggaa aagaaatgac aaagtaatta 18180
agagtgtaaa attaaaagga ttaatttttc ttaaaggccg atgagttaac aacacgcatc 18240
aatctctctt ccttctccaa acttcagaca aatgatggca aagtaatttt taagaagtca 18300
atttatagag gcaaaaaacc tgaagtacag agagtaggaa agacagtaat agaattgaga 18360
gcagttgaca tccataacat tcctattatt acctccattt tctggataag aatatggaga 18420
agaggaatcg ttaagcaatt tgctgattgt cacatattca gtaagtggca aagttagtat 18480
tgaaacccaa gtagtcttgt tttaaagtca tacactcaat cactgtgcca taattcaata 18540
aattgtgaag gatgggaagc agatggagaa gtgattgatg aagcaggact gagaaagtgc 18600
tgcctatgtg cccacagtgt gaagacccta caagacatca gaacatcatc cagtgaagct 18660
gtgagcagct caccacttgg aaaaactgag tgttttggaa ggcagggata aagtgcagtt 18720
ctgaaaagag aaaaatccat caagttctaa acggtcgcgc tctcttaccc cacagtgggc 18780
aatggtctct ccattcatca ttttcttttc cctgagtccc ttgaatctta aatatactat 18840
tctgtgaatt aaacatggta aacattagac tttgaccagc gctattatca gaagttcaca 18900
tacctaatca aaggacctgt aaccttcttc ccctccttag tttctacacc accagtagcc 18960
aattatacta tcccagctcc catcctaaaa tccccttcta aaatagaagg caaaagatca 19020
tcagtcattt gagcaaaatt tcagcatgac agcatgagta gttgagacct atagtaacaa 19080
ctaaaatgga ctgggataaa acaaataatg tttggaatca aagaacagga aaaatacaac 19140
cgatattgga gcaagaaaaa ataaaaaaga atatgaaaaa tagataagaa atagctattg 19200
gaaaggtaca agaaatacaa ttttaaaacc agtggaacat aagacaaacc acaaaatgag 19260
aaaattctat taataaaagg tcgggggtcg gggaactgta ttcttttttt tttttttttt 19320
ttttttaaga cagagtttcg ttcttgttgc ccaggctgga gttgcaatgg cgcaatctcg 19380
gctcactggg caacctccac cttctgggtt taagctattc tcctgcctca gcctcccaaa 19440
tagctgggat tacaggcatg cgccaccacg cctggctaat ttttgtattt ttagtagaga 19500
ttgggtttca ccatgttgat caggctggat ggtcttgaac ccctgacctc gggtgatccc 19560
aaagtgcagg gattatgggt gtgagccacc gtgcccggcc actgtatctt ttaaaaatgt 19620
aattgtcatg gaaggcaaga aaggtttagg aggctttcca tattgaagag gactgaggag 19680
acatggcaac taattgcaat acatgattct agactgcatg caatactgga ggaaaatcat 19740
gctataaaga attgactcaa ttgataaaat cagaatacta gcagtagatt acatcaaagt 19800
atcgtatcaa tgttacattt actgaatctg actaccatac tatagttaag taagagaata 19860
ttcctatttt taggaaatac agaagtgttt agaggtaaag ggtcatgata tatacaactt 19920
aacaaaagac ttagacaaat atggggtatt taaataaagg agaatgacgt gcaatctgag 19980
aacaagaagt ccaacagaga aaagcaaaaa tagggagtca gcgagcaacc agtgagatgg 20040
gagcagaagg atggaagggt ggaggagtga catctaaaca tattaagaac tcaaatatgt 20100
tgattatttt gtatatctga agtttgaaat tatcactgac aatcttctaa acttcaggaa 20160
aaatgaggat actgtgctac aaatgtaaac ttaagaacaa tatttacata gtcatcataa 20220
tgtaattatg aaatactgat ttcaccaaaa ccaatttgat ttaacacatc gagagaacag 20280
tgggaataga gtcctgtaat tggtgcacct gtcctaattc ctatgtaggt attataatag 20340
aaagttaata ggtaatgttt aaaattgata aatcaagata acaatatcag catgttaggt 20400
taaaaacaag gtaattacca aaagcaccag ataaaagagc caaacattgc tttctctatt 20460
gaacgggact acagcataga gaagtgttaa gcaagctgcc attattcttt tgctcttatt 20520
ataagcctct taatactatt tgattactag ctcatgagct cctatttata aaaataaaag 20580
caaattttcg aagtcagaac aattcatgct gctacaaaat ccctaaagtc atttcaacaa 20640
tacagcacac tgatgattat atagacattt ttcttgtctg agttctttgt ctagaaactt 20700
tttaaaagaa acgtggtcct gtattacatg tagcatgctt tggaagaaaa actatctcca 20760
atcaaaaagt ttttaaaaga gcccagatgt tatcgtcctt tgtatctcta aaagcaattg 20820
cttttataaa attaggatct actctttttt gaaatttgaa tgctgaagtt ttgtgggttt 20880
cagcaaaaga taggcataac atacatctct acattttatt aaatatgatg gtgcagatgt 20940
taaaaatatg tttgaaatgc agtaccttct gttcttgctt tcaactccta ccctagagta 21000
aatgaaatgc taatcacctc ttgtgttagt gatagaattt gtgagtttcc acagataaaa 21060
tatgtttact gtaatttcca aatagttgat agccagtagc aatatcttga cttcagcaac 21120
tggtatgtaa gggtctatat taaagtgttt atattatgac tagtataaca gatggtatta 21180
tttgttacag caggtcataa cactaaaaaa taaaactatt acacatctac aatttgatca 21240
caaattttag tggcagtgat cacttatttt atgaaagaga ggcagtaatt gccgaagtac 21300
tgcctaaaaa tgtaagacaa ttctcattac agggtaaggt aaaattattg acttattaac 21360
cagaaattca catctatccc gctacaggaa aaaaagtgta catttaatat ctactacagt 21420
cagttgagtt ttcaaagtaa tctgtcatct ctaccatgaa tatggggaac aggagaataa 21480
ctgctggatt tttggcattt gacacctaat atatagaact ttaaaggagg ttatctatta 21540
tataaataat ctttgaagaa gagcaattta tgtttttgga caaccaaaaa attacttgtt 21600
tagcttcaca ggaattttaa agcatgtttt cacttattat taaacagtaa cattgaatat 21660
actgctcttt tatcagttct catttttttc aacattcagt agatgacttt aaagaactct 21720
caccttcctg gttttctttc taaactgaga ttatttcttc tctcacttat gcacctattt 21780
tctaatggcc atgtctcaaa aaatttttat tctagcgtct tttttccttt tatcttggtt 21840
ttgctgtagt gctagataga tggttacttg tgagactttc aaatctatat accaggctcc 21900
aacttctctc cctctccctc tctttttgag taagggtttg gctccatcac ccaggctgga 21960
aggtcatggc tgattgcagc tttggactcc tgggctcaag ggatcctccc acctcagctt 22020
cctgattagc tgggactcca ggtgtacagc atcatgacta gcaattccat tgtttttaga 22080
aatggggtct tgctctgtcg accaggctgg tctagaactc ccagcctcaa gcaatcctcc 22140
tgcctcagcc tcctaacgtg ctaagattac aggcgtgagc caccacacct ggccaacttc 22200
taagtttcag tgctgtagtt ttaaattgtt tctcatactt atctaatatt ttttcccacc 22260
atgtcaaacc cttaaaaact cagtatggac aaaataaata ttaacttttt tgagattgat 22320
aattgtatga tagtgcttat tacctcaaaa gaattactgg ggcagcagta taatccagta 22380
gatgggggaa atagtggata ttaagaccga aatgggatca taacttttta gttgtatttg 22440
cccacattaa ttgttttaaa gggggtaaag gcctggaata tgaaaacagg aggatataaa 22500
atatatggag gttgtgaaag atgactcaga acttgaaaca attgtttcac tgcagtaaat 22560
acatgttgaa tgcatagaac agagaaaaac agaagaaaag aagaaggaaa aacaaactcc 22620
atgatttaaa atattgatga atgtgacaat aattgtatct ttaaaataac tgagaaatgg 22680
tagaaataaa aattataagc ttcaactgta tattacttat tcttgacaaa gatgatagtt 22740
gcaagctgaa gccaaaattt ctaactagga ctaatgcaaa gatttcaaga gaaactttaa 22800
taaagaatta ttgatgcaag cgctttcaga aagcaaaggt agggactaac cattagctct 22860
tgtttagaaa gataaaggtc acaaataaaa tttgtgtttt aatctataca ttttcagcat 22920
tatgtcatca taaatttgca tgttgtttat tacaaatggg aaaaggtttc ctgtaatata 22980
tcaagatgag ttttaatagt ttcaaggacc attgatttgt aaacttaaga ctattatagt 23040
gttgtggaaa attaaatata attggtgttt taggaaaagt tgttcattga agtttccatt 23100
ttatgtgcct taacagatta attttgctta ttaattctgt gatatttaag cactgctgta 23160
agcttcacag atttggcaat agccactata tacttaatga gtacaaacta tggagtattt 23220
ccatattaag gtagaagaaa tatttaaaag cacttctact tgtgatgtca ttgggggtgc 23280
aacacaatat aaagtacgca cattgctgga ggagaagcat aaaataaaga actcacgggg 23340
cagaaactta agacacacct aaatcaaatc tttgttttca gcattatctt tcattactat 23400
tctttgttac aaaaaaacat tgctatctgt ccttttctat atgttctcta cattaaaact 23460
tattatttgt atacatactg ttccctacat ctgcagtgcc attcccagct cacatatctg 23520
ccctcttaaa tttatatcaa attcaactcc cttcaaaaag ccttctcagt tgctttaacc 23580
caagccagta gtctgtcttc tagaaaacag ttgatgccga tgcctccttt tcctttagca 23640
actgaaaata atattatagt tatttaatgt gtgtgtgtgt gtgtgtgtgt gcataacatc 23700
atactattta gtagtatcta tatctatcaa gtatctgcta cagtggatga tagatgactt 23760
aaagacagaa atatgttatt catatctact tctcacaggt ctagtgctgt tgcaggatat 23820
tttttaagga atcagagaga ctgatggggt tcaggaggat atttattatt taggtgcacc 23880
agcccagtcg gattaacatc caaaggactg agccctgaac aaagagttaa gttacctttt 23940
aagcattttg tagggtggga ggagatctgt gcagggggaa gcatgttaga gaagtgagaa 24000
acaaagacag ttattcaatt aattgagaaa tgcgttacat catttcttac ttttcaagga 24060
aaaacatgtt ttgcgacttt tgtttatgtg tctagtgact ttgcagctgc ccagctaggg 24120
aatcagggtc ttcacaatgc ctgggaatgg aggggagaga aagctcatta gccacagaaa 24180
aataggccgt tagtttttta aaggactcta gctctttctc tttctcaggg ggaattggat 24240
tttcttacat acaactgagg ttctgcttac acattcttta atttctttta attcctgttc 24300
cagtgcagtg caatgttcat agtagatgct taatattttt tgaattattg tatctttagt 24360
cattgcgagc catcattttg agagtcagtc tcattctttt agccctagat tatttttatt 24420
ttcttgagat acgtgaataa agggcacagg aaaaaaacac agttgagagt tttggataat 24480
agtaacctaa ttcacccaga ttttacttca tattggttgg aactctaagt tgggtgcaac 24540
taacatgaga cttgttttga tttattgtaa acatattctt gaatgactaa tgaacagtgc 24600
ttcatgtgaa caaattttca ccttctgata atttccaata ttacactttg aaaaacattc 24660
ccattgtagt gctctagaaa atataatttc aattgttaaa attcaatatt actgtaattg 24720
aggatattaa ataacttgtt gttacatgat gctagctgca gcttaaattt cagatcatga 24780
gtgttgttaa tattatatag ttggaattag ttctgagatc aatgaatcaa tgctgtctta 24840
ctgttttgtc tttaattttt ataccacatt tattttgtga gtggatttca taaaaggaag 24900
ttgctttatg ttgccaagct cattatcttg ggtttttgtc cagagctgaa ttcccttttt 24960
catcaaagga cagagagagc ccattataaa ctattgagta atgctgattt gatgggtagg 25020
ccacttacct ttaagtggaa aggaggccag gcgcggtggc tcacgcctgt aatcccagca 25080
ctttgggatg ctgaggaggg cggatcatga ggtcaggaga tcgagaccag tctggccaac 25140
ttggagaaac cctgtctcta ctaaaaatac aaaaattagc cgggcgtggt ggcgggtgcc 25200
tgtagtccca gctactcggg aggccgaggc aggagaatgg cgtgaacctg ggaggcggag 25260
cttgcaatga gtcaagatca caccgctgaa ctccagcctg ggtgacagag cgagactcct 25320
tctcaaaaaa aaattacaca aaaatgttag actaataaat attaataaac actaaaggaa 25380
gaaatttagt ggaacattta tcagaggcaa cagaccagga agttatagtt accctgtgaa 25440
aaggcatcat ctaggattca tagaaaacat ttgcaaattg gcaacaacca ccaccacaac 25500
aaactaaaac aaatgaaaga aatagacatt tatacaggga aaatataaat agataataag 25560
tgtaataaat tttgtgactt tccacttgaa aacaaagaaa tggaaataaa acctatgtaa 25620
agaagtggtg gagtgagccg agctggggtg ggaggggtgg gggcatccca ggcagaggga 25680
acagcagatg caaaggtctg gaggctggag caggctgtga ggggtgagag cagcaagtac 25740
atgaagtcta gaccacaaat cgatgcttca ccctcaaaaa tagcctctca ctggccacca 25800
ctcaggccca gatacatgtg taaggtgggc agccttcagg aaaagtgacc gcaaaagtgc 25860
accacattgg gaattctgag gtgtttgaga aagttatgga tgaagggtga ggtagactct 25920
agtggggaat gtcctcttgc cacttggact tctctgtcta tttcatgggc tattatcaac 25980
ttctaaagag ccagtggttt gggtgcacat ttaggtgtaa gtacctcttg cctcaagcct 26040
taactctctt tccaatgagt caagtgagct gttgtgttta agtaacttct ctttattgtg 26100
aaatctttcc tatcacttta agaaccttct tcttcagacc caagtaatcc caaggcacct 26160
ataatgtccc tcctggagaa gacaaaaggg tgtcttctat ttctgtgtgg cccgatattt 26220
cagggcccct aaccaggtta gttcaaggtg ctcagcataa ccatgaatct gctacccatg 26280
tttctcaggt gggtcatagg ccctggaggg attgtggctg tggaccaagc agggggtgct 26340
gtgggctgtt ctgagaagga gggttttgga gtgtccaagc tgagaacata gaggccccag 26400
atgttgtatg agtaaatttt catctgacag aattatattt tcctaactga aaacatgaaa 26460
cagagatgta acaactgtgc ctctttggct ctgtctttgc atgctgtcat cagccactga 26520
acaggagctg agagggaaga cataaagaac agaaaaccca tgagggggat ggtccatgtg 26580
ggtgtggaag tgagggtgag tggggatttg gccaaagagg cctaatccac aggagtagag 26640
tctcatgtgt gactttcaga atgagcagga gtgagatagg tggaggggga gtgttggaac 26700
atctcatcag aggtgagaat ccatagaagg agacactggt cattacagtc agtgagaaaa 26760
gtgactttag cctgagccta aggtcattgg atcaaggaag gggccaggag gagctccttg 26820
aagggaagct gtgagcttga gaggcaggct gaggcagatc agtagaatga gcccccgaga 26880
agggctcaca gagtcactga aggactgtga ggtggcaggg acaagctcac atggcctttg 26940
gtcagtgagt ctccagctgt aatgagaatg aaatggggaa gatctgggac aggaagacaa 27000
gctgggggcg ctggtaccat catggggaga tgatggtggg tggctctagg ttagttagag 27060
ttggaatgaa gagcagaaag cagcttcgtg atacctttat gtcataaaat acatttggca 27120
tggagaggac ttggactttg tgcatgaagg atatggatgt ttctaggctg actcccaaat 27180
gtttctaggc tgactcccag aaactaggat gtttctaggc tgttcctggc tgagaatttg 27240
gatggtaact atagtccaaa gaaacaaaga acactgaaat catatcttat tttttttaac 27300
tcacaaaata gaggcaggta gatatttata tgtgttttgt tggctcaatg atttttttta 27360
gtaataaaca tatttactta gaaactactg ggtgtctgta tgctctggga tttttttctc 27420
ctgtcctgat gacatctctt tcctttctct gggttcagga gttacttccc aggttgtggt 27480
gacacaggaa cattcacttt ccacaactcc tggaggggca gtcaccttca cctatggctc 27540
caaaattggg gctgtcatca gagcatctcg acagctgggc ccaacagaac atctggcaat 27600
gtccccaggg caatggtggg cacaagcagt caggtcctgg gacccctgca caatcccctg 27660
gttctcttca tgaagaaaaa gccactctgg ttataatgag gactagacca agaatgaggc 27720
ccagtgttac atgctcggtg tggtgatctg aaatatcacc acagggacaa atacaaaaat 27780
acaagtggga aactacactc aaacccttgg atcaagcctc agtcctatgc ttctgaagca 27840
aatttcttgt ttttggagtc tggttttcaa ccactgtaga ctcagatcat ttattcttca 27900
ggcccccaat gggatcatca caagcacttt ttctatcaat catggcagtc acttgagatc 27960
aaaggtgaat ttcttcttcc tcaagttata agcaacactt tggcatattt ggtgaacttc 28020
aaagaaaatg gctaagatag aggatgagag acataagagg cttcaggaat atttcagcag 28080
atgcaaagca gactacaggg taactcattt cccatatgat ttgattgatt gcaaaatgtg 28140
aaattaaatg catacaaagg ggaatgtgtg tcatttttcc tcttaatgac aaagtaaaaa 28200
aaaagcaata aaacaaaaac aagcactatt tcatgtgtct tgataaactt gtagaaagtc 28260
ttataatatc cacaatatct aggatacagt aaaataactt tccatatgaa gaaccagaag 28320
aacacaactt aaatgagaaa agacaattga tagacaccaa tactgaaata atttaggtgc 28380
tgatgttatg taactgagat taattaagga gtaattatac aattccttca gtgagcaatt 28440
ttagacatta ttttttgaag ttttaggttc aggggttcat gtgcaggtat gttacgtagg 28500
taaacttgtg tcagagggga cattcttgaa acaagtggaa aagaagcaaa tcccgaaaag 28560
aaaaataagt catagaaaca aaccaaatta aaattagaaa acagaaaaat gcaataaatt 28620
aaaaagaaca gtctggaggg actctggaac aggtaacagt gaaattaaag ttcaggcatt 28680
agaggaatta tttaccgtta agtagggaag aaagtacaaa caatagccat ctaagcccag 28740
cagagggagc tgtggatctt ctcagaggtg agcaaggccg gaaatgaact cccggggctc 28800
tcatttatgg ctcctgggtc catactcact ggcccgaatt ggggtttaga gcaggtgctt 28860
tctcccaaag ggcaaactca gagttcccag cagcccatcc tccctgacag agcggctgct 28920
gcctggctga gcactcagaa cttagggagc cggtggtttt ggtagaggcc ccatgtttgc 28980
ataatgtcct aaccaaacac acatctaccc ggggaggtga cgaggagtta gaggaactgt 29040
cccagggtcc agaagtagcc gggggttctg gggatccttg gaaagtccac accatagctt 29100
ggatgtctat cctcccctct ctccctcctc actgcccagg ttcatgtaga tttcaaagac 29160
aggactttgg agggatctgt ctgctgtgat tcctcacaca taacatgtat ctgttttagt 29220
ttcttggttc agttctcagg ctgtggtgac tcaggagccc tcactgactg tgtcctaaag 29280
agagagactt attctcatgt gtggcttcag caccacagca ctgaattcag cagaagcctg 29340
gtcaagtcct caggacattg atgtgtaaca cagataacaa acacccctgg atgcccactt 29400
gattctctgg ctccctcctg ggggaaagct gccctgaccc ctcaaggggc ccagcctgag 29460
gatgaggctg agtatactgt gggctacacc acagtggtcc ttagcacagt gagagaccca 29520
gatggggaag caggacatga acgagctttt ggctgatccg gggtacaaac atgaacgtag 29580
gatatcagga tcacgtggcc agacacctga gctctcaagg acacctaaat tttaactatc 29640
cgtagagaga aaggtgggtg gaggggtgta aattgattcc tgtatctgtt tgaattttaa 29700
agtggaaaat atttgtgaat catttgggag atgcagattc ccaaaaagaa gaatttatgt 29760
ttatattcca aacagaacag taatagtgag atcaactcta aagactaagg tcaaacacac 29820
ttcatccaga aagatggatc tcaaaagatt ttgttgttgt tttgcctatt aaaagctaag 29880
agaggaaatt atattaataa agtttatttc atgttctatg ttaatagtgt gtatttcata 29940
gctttttaag cattaaaaat tataaaagtg ttaagaggga ttctcttctc taatgttata 30000
taagaaagta tccacctagg aaaatatttt gaaggtctaa cccccagtac ttctaaatgt 30060
gaccttattt ttaaaatagt gttattgctt atgtaattct taggatgaag ccatcctaga 30120
gcgaggtggc ctcttgatcc aatgtgcctg gtgtccttat aagatgatgg tagtaaggag 30180
attggaagac acagagagaa tgccgtgtga cgacgaaggc agagattgaa tttacacagc 30240
tgcaagataa ggagcactaa agattgctgg caaaccacca gcagccagaa agagggaagg 30300
aaggatctcc cctcaggtat atatggaaac attgcccttt ctatgaattt tgggaggcta 30360
gcctccagaa ctgtgagaca atacatttgt gttatcttaa ccaaacttgt gtttaataca 30420
ttctgacagc agttctagga aaccaataca ccagacaata aattacacaa tacttctgaa 30480
attgattgta cttctttcat tttggcaacc agtttttcca tgaatatgat tatatctgtg 30540
ctcatatttc taactttata aatatgcttg taatttaagg ttaagataag aaatccttgt 30600
gtcttaaaaa tccctaaata tatgagaact gaataataat attaacatta tgagatctaa 30660
tggaaaattg tagcttttac ataattccac ttgttcacta gtatcaagat gtgaaggtgg 30720
gaagatcacc ttgttattaa caaaacactc ctggtcatct ctgtggattt gagagtgcag 30780
ggggagacac ctacatattg tttgggaagt cacaaatgca gcatgcccag agcatcatgt 30840
acaacagtgt gagtttgctg gacatgtggg caggacgcag aacagactgg ggcatgagga 30900
accacctatc accaaaccca ccagcgcctt cctccctgga tcagcccaga gctgctcaga 30960
cttgaatgtg cacatggatc atgtgggatc ctggataatg tggattctga tcagtgggtc 31020
tggactgtgg actgaaattc tgcgtttcta gaaggcccct tcttccaaag atccacatac 31080
atgttttaat attaccatat tcataagaat ggtgggaaat aagggaagcc actttcagac 31140
agaaaccaaa tagaaattta tctgagaggg agctaaagga ttatgatcaa agagaaatcc 31200
ccaattccag gcagggagct gatcacagag ggcagatggg aagttgggag aggttctatt 31260
tttttttttt taagaaatag aaatgaatgc aaacacaact caaacctcct cttgatccaa 31320
catccctgct ggctcctgcc caatttctgc actggcttct tctccagtct tttcccaagc 31380
atggaccctc ctcaccctct ctgcttcccc atctcaaact cacaacttcc cttctcagtt 31440
ctcctgtttc tctccctttc attccacttc cttcttctct gtgacctcct tagacaatca 31500
ccaaaatatt tctagaagaa aagccatggg tatttttcat cttttcttga aagttgtcac 31560
tcacattccc tcttcgttct tcagcctctc ttacccctta ctacaaaaga tgcctgaggc 31620
cactgtttct cttttccatc ccctcaaata gcttctcctt ccaacccgtt tctctcctca 31680
gttactagag cattcagtga agcactcagt caggttaaag gatcctccca aatgctcacc 31740
ctgctctcta tgtgtgatct cctgaagaat caagtaggga gagaaacatg gcttcatgag 31800
tttgtgggga agtgggtgca tggctgaact gtccttgttc tcagcaaatg tactttattt 31860
catgcacagt ttgtatatga gacaaccttc tcctgcggac tccttataaa atgggaagaa 31920
ttatgtgttg tgttttcaca gaggaagccc aaatattcca tgctcatggg taggaagaat 31980
caatatcatg aaaatggcca tactgcccaa ggtaatttat agattcaatg ccatccccat 32040
caagctacca atgactttct tcacagaatt ggaaaaaact attttaaagt tcatatggaa 32100
ccaaaaaaga gcccgcatcg ccaagtcaat cctaagccaa aagaacaaag ctggaggcat 32160
cacactacct gacttcaaac tatactacaa ggctacagta accaaaacag tatggtactg 32220
gtaccaaaac 32230
<210> 75
<211> 117
<212> PRT
<213> Intelligent
<400> 75
Met Ala Trp Ala Pro Leu Leu Leu Thr Leu Leu Ala His Cys Thr Gly
1 5 10 15
Ser Trp Ala Asn Phe Met Leu Thr Gln Pro His Ser Val Ser Glu Ser
20 25 30
Pro Gly Lys Thr Val Thr Ile Ser Cys Thr Gly Ser Ser Gly Ser Ile
35 40 45
Ala Ser Asn Tyr Val Gln Trp Tyr Gln Gln Arg Pro Gly Ser Ala Pro
50 55 60
Thr Thr Val Ile Tyr Glu Asp Asn Gln Arg Pro Ser Gly Val Pro Asp
65 70 75 80
Arg Phe Ser Gly Ser Ile Asp Ser Ser Ser Asn Ser Ala Ser Leu Thr
85 90 95
Ile Ser Gly Leu Lys Thr Glu Asp Glu Ala Asp Tyr Tyr Cys Gln Ser
100 105 110
Tyr Asp Ser Ser Asn
115
<210> 76
<211> 32230
<212> DNA
<213> Intelligent
<400> 76
gaattcactc atcaccaagg ggaagatgct caatcattca tgagggatct gcccccttga 60
tctaatcacc tcctagtggc cccacttcca acactgggaa tcatattaca acatgagatt 120
tggaggggac aaatatataa accatatcct tccacccctg gtcccccaaa tctcatgtcc 180
ttctcatgtt gcaaaataca atcatgcctt ctcaacagtc ccccaaagtc ttacctcatt 240
ccagaatcaa caaaaaattc ccaagtccca agtctcatct gaagatgagt cccttccacc 300
tatcagccta ggaaatcaaa gacaaattga ctcccaaaat acaatgagag tgcagacatt 360
gggtaaacat tcccattcca caagggagaa gttggcaaaa agaaaggatc tacatgcccc 420
atacacgtca gaaatccagc agggcagtta ttaaatctta aagctccaag gtaatctcct 480
ttgacttcat gtcccatatc cagggcacac tggtgcaggg ggtgggctcc caaagccttg 540
gacaactcta cccctgtggc tttggaggat gtcgcccctg tggcttctct cacacgatag 600
agttgagtgc ctgtggcttt tccagattca gggtgcaaac tgccagtgga tctaccattc 660
tggggtctgg aggacagtgg cccccttccc acagctccac taggcagtgc cctggtgggg 720
acattatatg ggggttcaac cccacattct ctttggcact gctctagtag aggttctctg 780
tgagggctcc atgctggcag gaggcttctc tctgggcacc tagggtttct catacatttc 840
tgaaatctag agtgaagatg ccaagcctcc ttcactcttg cattctgggg gcctacaggc 900
ttaacaccag atggaagttc ccaaggctta tagtggcttg cactctccaa agaagcagcc 960
taagctgtac ttggggccct ttgagccaag gctggagcca gaggaaccag gatgtggaga 1020
gcagtgtccc aaggctgcac aggcagcagt ggccatgggc atggcccaca aaaccatcct 1080
ttccctcttg gcctctgggc ctgttatggg aaagaccacc tcagagattt ccgaaaggcc 1140
ttcaaggcct ttttcccttt gttctggata tgagcactta gctccctttt agttatgcta 1200
atctctctag caactggctg ctccatagcc tacttatatt tgtctcctga aaataccttt 1260
tcttttctac cacatggcca ggctgtgaat tttccacatt ttttatgctc tgcttccctt 1320
tgttgatgaa aaaagccaaa ctccataaaa cacttgacga gattgattct gagccacatg 1380
tgagagccat gaactgtggc acagcctcaa aaggtcctga gaacacctgt gcaaggtggt 1440
tgggttgcgg cctgctttta tgttttaggg agacatatca atcaatacat gtaaagtata 1500
cattggtttg gtttggtttg gaaaagcagg acaattcaaa gtggggaatt ccaaatcata 1560
ggtggatttg aagattttct gattggcaat tggctgaaaa agttaaatta tctaaaaagt 1620
tgaagtcagc aaaaagcaat gcttaagata agggggttgt ggaagccaag tttcttgtta 1680
tgtagatgaa gcctccacgt tccagagaga agagatggtc aatgtctctt atcagaacct 1740
aaaaggtgcc agactcttgg ataaatctct cctgaatcag gaagagacct ggaaagggaa 1800
aaagattctc aacagaatat acatttcctc cacaagagac ggctttgcag ggcccttcca 1860
aaatgtgtca gagaaatata ttctggcata aaatacttta atttccttcc atgcctgcca 1920
cctgtcatgt gatgctatac cagaatcagg ttgggatttg atatcttatt gctacaaaga 1980
gtctgctttg tcagtcttaa gctccctgtt ttaatgttaa cactggtcag ctgagcctaa 2040
gctccaacag ggagagggta tagtgaggga gtccaaacca ccctcccctt cctgtcatgg 2100
cctgaactgg ttttccaggt ttctttggaa tccccttgga ttagcatttt attttgtcgt 2160
ttacaccttt taaatataag ttccaacttt aagtcatttc tttgctccca tatcttacca 2220
tagactgtta gaagcaacca ggtcacacct tagaaacatc tgcttagaaa tgtcttccac 2280
agatgcccta agtcatcact cttaaggtca accttccaca gatccctagg gcatgaacac 2340
aatgcagcca agttgtttct taggatttaa caagcgtgac ctttacacca gttcccaata 2400
agtttctcat ttccatctga gatttcatca gcctggcttt cacagtccat atgtctatca 2460
gcattttggt gacaaccatt taatagtctc taagaaattc caaactttcc ctcatcttcc 2520
tgtcttcttc tgagtcctcc aaattcttct aacctctctg cctgttacct gattccaaag 2580
ctgcttccac attttcaggt atccttatag caatgttcca ctcctcaata ccaatgttct 2640
gagttagtct atttgtgtta ctagaaaaaa aaaaaaaaca tgaatctggt aatttataaa 2700
gaaaagaggt ttgcaccagg cactgtggca aggaagggag gattaactag ctcacagttc 2760
tgcagccatt ccggaaacac ggccctggca tctgcttctg gcgaggcctc agggagattg 2820
caatcacggc agaaggcgaa gggggagcag gcatgtcaca tggcaagagg gagcaagaga 2880
agagaagtgg cacgtcctag acttttaaac aaccagctgt cacagggact aactgaggga 2940
gaactcactc atcacctggg agatggtgct aggccattca tgaggggtcc agccccatga 3000
tctaatcacc tcccaccagg cccacctcca acactgggaa tcacatctca acatgaaatt 3060
tggagagaca cacatccaaa ctattgcacc acaggaagct ggaagaggtg gacggtcctc 3120
ccctggagca ctcagagaca gccaccaaca ccttgatctc agattcctga ctcccagaac 3180
tctgaaaaaa tttttgttgt tttaagccac atttgtgata ttttgttacg gcagccacag 3240
cacggatata gctggtaaca gagttcttta gcctccaaaa tacaagcctg gggtaaataa 3300
ctattgaatt tggccacatg gaaatcagga agaatgtaat aagcatcatc gatggacggg 3360
atgacctggg agatcgtggc aagtttaaag ctaattggaa gttggcaacc aaaaaatcct 3420
gtcttgcaaa ttgccaggaa attgccaaga aaacttttag aaaacatggt taaagatgga 3480
gaaacctgga tgaatccctg gtttctgaag aggtgcttag gcattgaagt gagactgatg 3540
agacttcaca ctgtaccttc agaagggcag acactcacga gatcatcaac cacggctccc 3600
tcgctgggag gcagacacag agctggaggc ggcggccaca aactaggtgg gcagagaggc 3660
gtcagcatcg ggacttgcgg gaggccctgg gaaggaacag gcagcggtgg ggcctggaca 3720
gccctgggga aaggaagtta cttggaggag accaggggct tgcatttggg ccaaaaccaa 3780
ggacaagaga tcagctggtc ccagggaact ctggagccca gcaccccacc acgggtgcag 3840
ggtcctgaca acccgagagg gctgtgggca ccgggcacca gcctgtgggg attctgaagg 3900
ctgctgccca gccacacgtc ccggttctga acaaagggtt caagagacac ctgcaaacct 3960
acctttctga gagcagcctc ttagcctcag ctggtattgg cctttggtca ccccacatgc 4020
cccgacagtg gggcctggcc tcagaaaggg gcccctccat ttgtactttc tatctgatcc 4080
ttgacacagt gctaacacca aagaccaaac ccgaatcttg gttcacatac tctgcaaaga 4140
aatgactaag actagttctt ccggaggtca gttttagaac gtttattctg acttaattct 4200
gccttatctc tgtgcaccaa gaaaactatc tgcacatctg tagtaaaatg tgaaggtacc 4260
ttcattttgt ttgtatacta aacttttaag aaatacctca ctttttaaaa cttggttttg 4320
tgttttgtat gcttataata ttttccataa tagatcattt taatgatgaa ctctgagtct 4380
tctgacagaa tgcagatcaa tggattccta gccatcaggg aggcgttgat tgcaaagggg 4440
cctggtggaa tttttggaga gattctacat cttcttgcaa ctgttcatct ggattacggt 4500
ggtggttgca tgactgtgca tttgttgaaa cttacatgtc acaggatgga ttatactgaa 4560
tgtaaactac acttgagtaa atatgacttt taaaacttta aaaagttggg ggatggttca 4620
ctgccccggc tcgaagcccc ctggccacgc tgcctggcca gcccaccccc atccctgcca 4680
gcgcttgcct ccagcgtccc aacagcctcc tgaccccctg ggctgctcta aaccctcagg 4740
agcgcagcca tccgggatca gctggatgga gatggggagc ccgagactcg tgccacacca 4800
cgtcctcccg cccacaccag ccacacgcag acgtcaaagc agcactgtcc tcgcacgcac 4860
tgctcccacc caccctggca cggccattcc aggcctgggg caggaaggca gatgctcccc 4920
ctgcccccag acacaagcat tcctgcacac acccccagca cacacacgca ctcccatgcg 4980
cacactgaca cacacaggtg tgtgcagctg agacacagcc cgttcccagg aagcccagcc 5040
cccatcactg agggaaaggg gcagcaccgt agggccacag gagtggcagc tggacacaga 5100
gccaggagct ggtgaaggcc caggccactg aggcgggctg ccggcatggc tgggcgtgaa 5160
ggccagaaga gggcaggagg ggctgggggc actatgccta ttgggcctag gtgggcacac 5220
gccgggcagg agaggaacag cccagcccct cagacaggaa ggggtggggg caggggccat 5280
ttgtggaggc cagggcaggg ccagcacccc aaggaaaagc agagcagggt gagaacggac 5340
atggggctca gagctgagca ggcctgctgg gccccaggag ggagacacag atgaccggag 5400
atctcaaggc tggcagaggc cagagatgga gccccagctg ggaagccatc ctccttcctg 5460
ggggcccacg ctgcccggcc cctccagccc agcaagcttg gggcattgga tagaaccggg 5520
agagagccga ccaggcactg aggcccctgc cccaaatgcc cacagcctgg ggaaaatgag 5580
caggtacatg ggaggggcaa gtggagcccc aggcacaccc acacagtgca cacggcctca 5640
cctgggccgg agggggcagg aggctcgcca ccccgctgtg gtttctctcc taatctcacc 5700
ctgggtttct ctcacacttg atgcagatga tgtttctctg acattgtgga ctaagagttg 5760
gtgctggaag gggttagcca tcttggagat gttgctatgg gatgcaggga ttttgcgtgt 5820
gagaaggaca tgattatggg gggaacggag ggcaaactgt catgggttaa aatgtgtccc 5880
ctataaattc atgtgttgaa gtcctaaccc ccaggaccgc agaatgtgac cttgtctgga 5940
aacagtcttt gcagctgcaa tcaagttcag atgaggtcac cctggagtag ggcaagcctc 6000
tgatccaata tgactgctgt cctcatgaaa agggggaatc tgggcacaga cagcacgtgg 6060
ggagaacgcc ctgtgaagat ggtgctgctt ccataagcca agagcaccag agacggccgg 6120
caaagcccag cagcaaggag agagcctggg acagagtctc ccatgacaca gaggagccag 6180
ccccaccgag gcctccatcc cagatgcccg gcctccagaa ccaggacgga ataaacgtct 6240
gttgtttaag ccacgcagtc tggggtgcag tgttgccagg gccacagtta acggatacga 6300
gtgttgtcct gagctgccag ccccacaggc tgcacgaggc ctccctgccc cagcccagtg 6360
cagactcccc agccccctgg gtgtgccatg ggcagtgggg ggcccctcac tccgtcctcc 6420
cccagcctgg gaggttgagc ccattatgag ctccatgggg tgaagctgga acgagaggct 6480
gggagccgac tgggagcctg cggctggagg atggatttcc ccagggaccc acacgtgcac 6540
ctccacctgt ctcctggaca ttctctctga gggcagggct ggtgccagct cagggatcca 6600
gcagggtcac aagggcaggc cgggtccttg tggagagcac atttagtggg agggacatga 6660
tttcccttca aagtgcccat tctggacgct tcccgttcca tgctggacgc ttcctcttcc 6720
acgctggatg cttcctgttc cacgctggat gcttcctgtt ccacgctgga tgtttcctgt 6780
tacactctgg atgcttcctg ttccacactg gatgcttcct gttccatcct ggatgcttcc 6840
tgttccatgc tggacatttc ctgttccact ctggatgctc cctgttccat gctggatgct 6900
tcctgttcca tgctggatgc ttcctgttcc atgctggaca tttcctgttc cactctgcat 6960
gcttcctgtt ccactctgga tgcttcctgt tccacactgg acgcttcctg ctccacgctg 7020
gacgcttcct gttccatgct ggatgcttcc cgttacattc tggatgcttc ccgttccatg 7080
ctggacgctt cctgttccac gctggacgtt tcttgttcca ctctggatgc ttcctgttcc 7140
acgctggatg cttccttttc cacgctggac acttcctgtt ccgcgctgga cacttcctgc 7200
tccacactgg acgcttcctg ctccaggctg gacgcttcct gttccatgct ggatgcttcc 7260
tgttacattc tggatgcttc ccgttccatg ctggacgctt cctgttccac gctggacgtt 7320
tcttgttcca ctctggatgc ttcctgttcc acgctggacg cttcccattc cactctggat 7380
gcttcctgtt ccatgctgga catttcttgt tccactctgg atgcttcctg ttccatgctg 7440
gatgcttcct gttccatgct ggatgcttcc tgttccatgc tggacgtttc ttgttccact 7500
ctggatgctt cctgttacat gctggatgct tcctgttcca tgctggacgt ttcttgttcc 7560
actctggatg cttcctgttc catgctggat gcttcctgtt acattctgga tgcttcctgt 7620
tccatgctgg acatttcctg ttccactctg gatgcttcct gttacattct tgatgcttcc 7680
tgttccatgc tggacatttc ctgttccact ctggatgctt cctgttacat tctggatgct 7740
tcctgttcca tgctggacat ttcctgttcc actctggatg cttcctgtta cattctggat 7800
gcttcctgtt ccatgctgga catttcctgt tccactctgg atgcttcctg ttacattctt 7860
gatgcttcct gttccatgct ggacatttcc tgttccactc tggatgcttc ctgttacatt 7920
ctggatgctt cctgttccac tctggacgct tcccattcca ctctggatgc ttccttttcc 7980
atgctggacc tttcttgttc cactctggat gcttcctgtt ccatgctgga tgcttccttt 8040
tccattccgg acacttccta ttccattctg gacacttcct gtgcgacacc tcctcgggct 8100
tttggtctgc ccagtccctc tggcctcata ccatcccccc ttacctccca cttccacgtt 8160
cgtccttcct cagctcctcc ctctctctag agcttcggcc tggcaaggtc cctcctgatc 8220
tcagtccagg ctcccccagc acaggtagga gacttgcacc tgcccttgga cctccccacc 8280
ctgcatgatg ccagcatccc ccaggcccca gggaggcccc atttctctct ctgcttgtag 8340
tccagtggcc ctggagtgcc actgcaactc gggtgtgccc ctcgcctctg aggaagctaa 8400
gtgccctaag ctaagcagag gccatcccct ctgctcagcc ccagggccct gccccctacc 8460
ccttcccctc acctgcacca caggctctgg ccaactctgc ccaggctctg aatgggcccc 8520
tctggctccc ctctgctgct acactgccct gcaccacctc cactcagctt cagtgtgttc 8580
atccacctgt cccacgtccc ctcggccccc aggagcacag ctggtggccc tggctcctgg 8640
cagcccatct tgttccttct ggagcaccag cctcagaagc cttcctgtgc agggtccact 8700
cggccagccc tgggaccctc ctggtctcaa gcacacacat tctccctgca gccagacctg 8760
cccctgcctg tgagctcaga cctgagcctt ggaacgcctt cccttctcca tcccagctcg 8820
cctttgccag ctgctcagcg ggatgaactc acactcccct ccctgcacca tgagtgagag 8880
ccagctggag agacgcccag gccaaagcag ccaccagggc ccagtggggg tcagaagctt 8940
caggtgagag gcccaggtat tgagaggctg agaccacggg cagaatggtc ataatcactg 9000
ccagtatcag tccagcccca gggactcaga gacagagaaa agagcagtga acaaggtccg 9060
ggctccccac cttctcccac gagtatgggg gcagccacca cccccatccc cacacaccca 9120
tgaggcagcc tcggctgtgt ctggactccc ccttaccctg tgacacagaa accaccagaa 9180
gaaaagggaa cttcaggaag taagcggtgc cgccggtttc aatcctgttc ttagtctttg 9240
cagcgtggag ttcacacccc tggggacctg agggccgagc tgtgatttcc taggaagaca 9300
aatagcagct gacggcgtgg gcaagtctgc ccacatgtac cgcgccaaaa caggaagggc 9360
tgagaccccc acctcggtga gtagggtcag cacagggcaa gggcacaggc tcgggaggag 9420
aaggacagag cctgggtgca gccgtgggcg ctcctggacc tcagctgctg aacaggctac 9480
aagaggctgg ggagacgtgg gggcaaggcc agccccacat ggagacccaa gcggagccag 9540
cacgggggag gtgggcagcc ttcaggcacc aacgcccacc cagtgcaaga tgacggggac 9600
cgtgggcagg ggcttccaag ccaacagggc aggacacacc agaggctgac tgaggcctcc 9660
atgacgacca ggctgggagc acgaggaacc tgacgggatg cggcagagcc ggccgtgggg 9720
tgatgccagc atgggcagga cccacctgag ctgaggaggc agtagaacga gggaggagga 9780
gaggccccag gtgaacggag gggcttgtcc aggccagcag catcactgga gcccagggca 9840
gggtcagcag tgctggccgt ggggccctct ctcagccagg accaaggaca gcaggtgagc 9900
cgggagcaga gcagggaggg tgagtgtggc agcaggacag gagggtggaa gccaaggagc 9960
ccagaggcag aggcagggac aggggaggca caggggctag gctcagagcc acctgatggc 10020
gctggggcac ctgctggcgg ggagcagggc tgtggtcagc agcggagtgg aggggagagc 10080
tgtgctgagt gcacagatgg gaggagggaa gagtccaggg aggcccagaa aggcccagag 10140
tgcagcaggc ctggggcgag gggaggggtg aggctccgtg cgttcaggga gctgacccag 10200
cagagcagag gccactgagg agctgaggtt ctggagaggc ttccagagca ggagcagtgc 10260
agggacggga ggatctggga gctcacccag gaggggcaca tgggcaaggg caaggggctc 10320
tgttggggag acctgactgg acactggggc tgctccacag catagggaac aagccaagtg 10380
ctgcaaaaac aaaaatgagg ccagaaaaac agcccaaacc tggacagagg gtgccaggac 10440
aggcaggggg gcaacagtga cctgagtgac attgctgccc gggttgaggg agggcagagt 10500
gagcaggggg caggcattgg agttcagggt accaggaccg agcagccaca ggtgagcagg 10560
gcaggtgggg gcagaaggag cagggggcac ctcctggagc tcagcagacc agggcagagc 10620
aactgaaggt gaacaagggc aggtgggagg caggatgagc agggggaaga ccctggagct 10680
caggggacca gggcagagca gcctcaggtg cctcaggtga gcaggggctg gtgggtggca 10740
ggacgagtag gggacagctc ctggagctca ggggaccagg acagagcatc aagagctgag 10800
catggctagt gggaggtggg cgaacagggt gcagcccctg gaactcggga ccagggcaga 10860
gcagcggcag gtgagcacgg gctggtggga ggcaggagga acagggggca gctctgggac 10920
ttcaggggac caggggaggg catctgaagg tgaacagggg ctggtggggg caggaagagc 10980
agggggaagc ccctggagct caggggacca gggcagagca gccacaggtg agcaggggct 11040
ggtaggaagc aggaggagca ggggacagcc cctggagctc agagcaccag ggcagagcac 11100
cctcaggtaa gcaggggcag gtaggaggca ggacgagcag gggacagccc ctggagctca 11160
ggggacagag gagagcatca gaaggtgagc aggactgagg cttagcctca gggaatcaga 11220
gcagagcagc cacaggtgag cagggccggt gggaggcagg acgagcaggg gacaggcact 11280
agagctcagg gcaaggcaac cacaggtgag cagggccggt gggaggcatc actcagctcc 11340
tagattttgg caggagctgg gtagttgctg gcagcagaca gctgagggct ggtgaaagtg 11400
cagtgcagcc tcctggtgcc aggaagggag tgtgagccca tcccactgag cagttggcaa 11460
gggtgagctg ggatggagaa gggaaggcat tccagggctc ggggctgagc tctcaggcag 11520
gggcaggtgt ggctgcaggg ggaatgtgtg cttgagacca ggagggtccc agggctggcc 11580
ccagcggacc ctaggcagga aggcctctga ggctggcgcc ccagaaggag caagatgggc 11640
tgccaggagc cagggccacc agcacaatga agctgagtgg aggtggtgca gggcagtgta 11700
gcagcagagg gctgccagag gggcccattc agggcctggg cagagtcagc cagagcctgt 11760
ggtgcaggtg aggggaaggg gtggtgagcg gggccctggg gctgagcaga ggggatggcc 11820
tggctgaggg cagggcactt agcctcctca gaggtcaggg gcacacccca cctgcagtgg 11880
gactccaggg ccactgggcc agcggcagag agaaatgggg cctccctgtg gcctgggggt 11940
cctggcacca cgcagggtgg ggagggccaa gggcaggtgc aaggctccta cctgtgctgg 12000
ggggcctggg ttgagcccag cagggacctt gccgggggaa gctctggaga gagggaggag 12060
gtgggctggt ggccgagaag gccaggccag ggctgggagg gtgaggttgt ggtgactgag 12120
cctccagaag taatgcagga cactgggagg cagggggcat ccaggcactc agggccctga 12180
cctgggctgc tgcacactgg ggctaagggg aaaggagggg agaggctgag gaggaggctc 12240
caggaggcta ttccaaggca gggggttccg gggccctggg gctgaagggc gccgacccta 12300
tgcagtgtct ggcccctctg ctgcacagaa gaaaagggcc ttggagggca gagggcaggc 12360
tatgaccagg gccctgggca agtcaggccc actcactagc ggagggccac gctggggcgg 12420
cagggtcagg agcttcaggg gactcggggg acccacgaga agccatctga gaacagtgtc 12480
cactggtcaa gccaggcacc cataaaaggc tggagtgggg ccaatgggca tgagccgtcc 12540
ctgaggtggc accgatggcc agagctgagg ccaagctaga ggccctggac tgtgctgact 12600
cccggcaggc acagagcgct gacctggctg ccgagccccg cctcctaggc tgcaggggtg 12660
cctgcagaag ggcaccacag ggccaccggt cctgcaagct ttctggggca ggccgggcct 12720
gactttggct ttggggcagg gagggggcta aggtgacgca ggtggcgcca gccaggtgca 12780
cacccaatgc ccgtgagccc agacactgga ccctgcctgg accctcgcag atagacaaga 12840
accgaggggc ctctgcgccc tgggcccagc tctgtcccac accgcggtca catggcacca 12900
cctctcttgc agcctccacc aagggcccat cggtcttccc cctggcgccc tgctccagga 12960
gcacctccga gagcacagcg gccctgggct gcctggtcaa ggactacttc cccgaaccgg 13020
tgacggtgtc gtggaactca ggcgctctga ccagcggcgt gcacaccttc ccggctgtcc 13080
tacagtcctc aggactctac tccctcagca gcgtggtgac cgtgccctcc agcaacttcg 13140
gcacccagac ctacacctgc aacgtagatc acaagcccag caacaccaag gtggacaaga 13200
cagttggtga gaggccagct cagggaggga gggtgtctgc tggaagccag gctcagccct 13260
cctgcctgga cgcaccccgg ctgtgcagcc ccagcccagg gcagcaaggc aggccccatc 13320
tgtctcctca cccggaggcc tctgcccgcc ccactcatgc tcagggagag ggtcttctgg 13380
ctttttccac caggctccag gcaggcacag gctgggtgcc cctaccccag gcccttcaca 13440
cacaggggca ggtgcttggc tcagacctgc caaaagccat atccgggagg accctgcccc 13500
tgacctaagc cgaccccaaa ggccaaactg tccactccct cagctcggac accttctctc 13560
ctcccagatc cgagtaactc ccaatcttct ctctgcagag cgcaaatgtt gtgtcgagtg 13620
cccaccgtgc ccaggtaagc cagcccaggc ctcgccctcc agctcaaggc gggacaggtg 13680
ccctagagta gcctgcatcc agggacagac cccagctggg tgctgacacg tccacctcca 13740
tctcttcctc agcaccacct gtggcaggac cgtcagtctt cctcttcccc ccaaaaccca 13800
aggacaccct catgatctcc cggacccctg aggtcacgtg cgtggtggtg gacgtgagcc 13860
acgaagaccc cgaggtccag ttcaactggt acgtggacgg cgtggaggtg cataatgcca 13920
agacaaagcc acgggaggag cagttcaaca gcacgttccg tgtggtcagc gtcctcaccg 13980
tcgtgcacca ggactggctg aacggcaagg agtacaagtg caaggtctcc aacaaaggcc 14040
tcccagcccc catcgagaaa accatctcca aaaccaaagg tgggacccgc ggggtatgag 14100
ggccacatgg acagaggccg gctcggccca ccctctgccc tgggagtgac cgctgtgcca 14160
acctctgtcc ctacagggca gccccgagaa ccacaggtgt acaccctgcc cccatcccgg 14220
gaggagatga ccaagaacca ggtcagcctg acctgcctgg tcaaaggctt ctaccccagc 14280
gacatctccg tggagtggga gagcaatggg cagccggaga acaactacaa gaccacacct 14340
cccatgctgg actccgacgg ctccttcttc ctctacagca agctcaccgt ggacaagagc 14400
aggtggcagc aggggaacgt cttctcatgc tccgtgatgc atgaggctct gcacaaccac 14460
tacacacaga agagcctctc cctgtctccg ggtaaatgag tgccacggcc ggcaagcccc 14520
cgctccccag gctctcgggg tcgcgcgagg atgcttggca cgtaccccgt ctacatactt 14580
cccgggcacc cagcatggaa ataaagcacc cagcgctgcc ctgggcccct gcgagactgt 14640
gatggttctt tccgtgggtc aggccgagtc tgaggcctga gtggcatgag ggaggcagag 14700
cgggttccac tgtccccaca ctggcccagg ctgtgcaggt gtgcctgggc cgcctagggt 14760
ggggctcagc caggggctgc cctcggcagg gtgggggatt tgccagcgtg gccctccctc 14820
cagcagcagc tgccctgggc tgggccacgg gaagccctag gagcccctgg ggacagacac 14880
acagcccctg cctctgtagg agactgtcct gtcctgtgag cgccctgtcc tccgacctcc 14940
atgcccactc gggggcatgc ctagtccatg tgcgtaggga caggccctcc ctcacccatc 15000
tacccccacg gcactaaccc ctggctgccc tgcccagcct cgcacccgca tggggacaca 15060
accgactccg gggacatgca ctctcgggcc ctgtggaggg actggtccag atgcccacac 15120
acacactcag cccagacccg ttcaacaaac cccgcgctga ggttggccgg ccacacggcc 15180
accacacaca cacgtgcacg cctcacacac ggagcctcac ccgggcgaac cgcacagcac 15240
ccagaccaga gcaaggtcct cgcacacgtg aacactcctc agacacaggc ccccacgagc 15300
cccacgcggc acctcaaggc ccacgagccg ctcggcagct tctccacatg ctgacctgct 15360
cagacaaacc cagccctcct ctcacaaggt gcccctgcag ccgccacaca cacacaggcc 15420
cccacacaca ggggaacaca cgccacgtcg cgtccctggc actggcccac ttcccaatgc 15480
cgcccttccc tgcagctgag gtcacatgag gtgtgggctt caccatcctc ctgccctctg 15540
ggcctcaggg agggacacag gagatgggga gcgggtcctg ctgagggcca ggtcgctatc 15600
tagggctggg tgtctggctg agtcccgggg ccaaagctgg tgcccagggc aggcagctgt 15660
ggggagctga cctcaggaca ctgttggccc atcccggccg ggccctacat cctgggtcct 15720
gccacagagg gaatcacccc cagaggcccg agcccagcag gacacagtat tgaccaccca 15780
cttcctgtcc agagctgcaa ctggaggaga gctgtgcgga ggcgcaggac ggggagctgg 15840
acgggctgtg gaccaccatc accatcttca tcacactctt cctgctaagc gtgtgctaca 15900
gtgccaccat caccttcttc aaggttggcc gcacgttgtc cccagctgtc cttgacattg 15960
tcccccatgc tgtcacacac tgtccccatg ctgtccccac atgtccctga cactgtcccc 16020
catgctgtcc ccacctgtcc cggacactct cctccgcgct gtcttgacct gtgcccaaca 16080
ctgtccccca cgctatcccc ccatccccaa caatgtcccc cacagtttcc tcctgtcccc 16140
tatccccgac actgtcctcc acactgtccc cacctctccc tgtcactgtc gcccatgctg 16200
cccccacctg tcccaacact ttcctccaag ctgtcctcac ctgtccccaa cactctcccc 16260
cacactctct ccacctgtcc ctgacactct cccccatgct gtccccacct gtccctgatg 16320
ctgtcctcca cactgtcccc acctctccct gtcactgtcc ccatgctgtc ccctgtccct 16380
cacactttcc tccatgctgt cctcacctgt ccccaacact ctcccccact gtctccacct 16440
gtccctgaca ctgtccccca cactgtcccc acctgtccct gatgctgtcg tctgtgctgt 16500
ccacatactg ttggtgacct ggctctgttc tccaagttca agcctcagag caggcagtgg 16560
tgaggccgtg gcacctgggt ggcctgaggg gtgggcgggc cttgggggca gggctgtggc 16620
ctcgctcacc cctgtgctgt gccttgccta caggtgaagt ggatcttctc ctcagtggtg 16680
gacctgaagc agaccatcgt ccccgactac aggaacatga tcaggcaggg ggcctagggc 16740
caccctctgt ggggtgtcca gggccgccca gaccccacac aggagccgtg ggccatgctc 16800
agccatcacc caggccacac ctgcccccga cctcaccgcc ctcaacccca tggctctctg 16860
gcctcgcagt cgccctctga ccctgacacg ccccccttcc agaccctgtg catagcaggt 16920
ctaccccaga cctccgctgc ttggtgcatg cagggcgctg ggggccaagt gtcccctcag 16980
caggacgtcc ctgccctccg gcccgccagg tgctcacaca aaaggaggta gtgaccagca 17040
tcccaggccc ccactcaggc aggacctcgc cctggagcca accctgtcca cgccagcctc 17100
ctgaacacag gcgtggtttc cagatggtga gtgggagcat cagtcgccaa ggtagggaag 17160
tcacagcacc atcaggccct gttggggagg cttccgagag ctgcgaaggc tcactcagac 17220
ggccttcctc ccagcccgca gccagccagc ctccattcca ggcactcccg tgaactcctg 17280
acatgaggaa tgaggttgtt ctgatttcaa gcaaagaacg ctgctctctg gctcctggga 17340
acagtctcag tgccagcacc accccttggc tgcctgccca cactgctgga ttctcgggtg 17400
gaactcgacc cgcagggaca gccagcccca gagtccgcac tggggagaga aggggccagg 17460
cccaggacac tgccacctac cacccactcc agtccaccga gatcactcgg agaagagcct 17520
gggccatgtg gccgctgcag gagccccacg gtgcaagggt gaggatagcc caaggaaggg 17580
ctgggcatct gcccagacag gcctcccaga gaaggctggt gaccaggtcc caggcgggca 17640
agactcagcc ttggtggggc ctgaggacag aggaggccca ggagcatcgg ggagagaggt 17700
ggagggacac cgggagagcc aggagcgtgg acacagccag aactcatcac agaggctggc 17760
gtccagcccc gggtcacgtg cagcaggaac aagcagccac tctgggggca ccaggtggag 17820
aggcaagacg acaaagaggg tgcccgtgtt cttgtgaaag cggggctgct ggccacgagt 17880
gctggacaga ggcccccacg ctctgctgcc cccatcacgc cgttccgtga ctgtcacgca 17940
gaatccgcag acagggagac tcgagcggga gtgcggccag cgcctgcctc agctgtcagg 18000
gaggactccc gggctcactc gaaggaggtg ccaccatttc agctttggta gcttttcttc 18060
ttcttttaaa ttttctaaag ctcattaatt gtctttgatg tttcttttgt gatgacaata 18120
aaatatcctt tttaagtctt gtacttcgtg atgggagccg ccttcctgtg tccacgcgcc 18180
tcctgccccc ggtgggaagc acggtcagga ggaggctggt ccagctgcac ctcgggggct 18240
ccctgcatac gccccccgcc tcctgcagcc acacgcattg cccgagcgac cctccctggc 18300
ccctgtcgct acatggaccc ccggggtttc tcctcttttc tacatggatg cagtttctcc 18360
tcctgctggg cacggtgctg cctgccctgg tcactctgcg ggggacaggg cctccaggga 18420
aagctgggtc gaggctggga gctggctcag gctgcccagg cagagccaca gggagggcct 18480
tccagaacca accatggtcc gaagcgagag gtgggtgtca gatctgtgtg agtcagctca 18540
ggaccacagc ggggcggctc ccacagcaga catggatcct cccaggccta gagaccagga 18600
atctgagatc aggatgcagg cagggctggt ttctctcaag ccctctctcc ttggcttgta 18660
gacaccgtct cctccctggt cctcacatgg ccatccctct gtgtgcccgt gtcctaagct 18720
tctcttctta taagaacaca catcggatta gattagtgac cccctatgaa cttaatgacc 18780
tctgtaaaga ccccatctcc aaatagtcac attgtgaggc cagggattaa gacttgaata 18840
tatgaatttg taggggccac gatttaaccc atcacagtcc agactctggc ccccaaaatt 18900
catgttcttc tcacatgcaa aacacattca tcctgtctca gcatccccct gggcactagg 18960
tcatgtagca aggacggatt ttcaacagaa ataactattg caacagaaga aagagtccgg 19020
catgacctgg actcaccttc atctgtgcag aggccacagc cttgtaaagg gaggtggtag 19080
ggggagcagg gagggtgctc ggggctcagt cgtcggggaa gggaaaagtt gcccagcgct 19140
ggtcagcgtc cccgggatgg gacccgctgt gtctgtgccg gccactgttg aggtcaggat 19200
tctgtcctcc cagagcctgg agacacaggc cccatccttc ccaatgggga cacttcaggg 19260
agtggctctc aggtcccgag aaagaccctc ctgggtcaca ggaaatgcac agacatcggg 19320
aacggataga aggtcgtgtg gttgcggccc tctcagcaga taccctgaga aagggaggtc 19380
ggggttggtc caaacggtga gttctggtgc acggagcttt ctcaggcagg tgttgacggg 19440
gcaggggtcg gcctaggggt acggccagaa gctgttagaa actgttagtg tctgctcaag 19500
tctttacaag ccaaggttga ggccgagtgg agaggctccg aggagcctgg ctggaactca 19560
gtcaaggaca gggtcttgtt actgcagtgg ctgcggtggc tgcggtggct gcgaaatgcc 19620
gtcggagttg cctgtggcag gagagagacc atctcaccca ggaaggagga gtggttggat 19680
tcgtttgtgt ggcatcgagc agctggagct tcaccaaaca cagagttggg gactaaatcc 19740
ccagactcca ggccctgcca tgccgtggga aggctcgcca ctggagggtg cgctccaggg 19800
ggcctggcct gaactgggtg ctgaagccca gccctttaac tctcaggaca cgctgctgca 19860
gccccgcggg gggtgaggga gagagcacct ggggtgcagg gcgggcagct gctgcatcac 19920
cggctctatc ccaagcccaa ggatggcgtc ccagagatgc aggagagctt tgtccagaga 19980
aggtgccagc cctcagggac cctgctggag agatctccac cctctgccct tcaaggggcc 20040
ctacgggcct ccaggtgctc tggtggggtg ggctccagtc cactgtctga ggatggacgg 20100
cctggccagg ataaggaaag gaaacccagg acggtgccgg gctccgggtc attccgtgca 20160
ctgagcaggc tgagttggga agaagcagat gcttcctgca gctgctgccc cctgcagggc 20220
ctggcgcctg gaccaggttc ccctggggaa attgggcccc tccctgagcc acccggggcc 20280
cacctcccac tttctacctg ggaccgagca tcctccagag ggtcagccct cctgcgggaa 20340
caccatgccc agccccagga ccctccctca actctccagc aaggctgccc ctgcacaccc 20400
cccagcagcc catgctgtga tgtaacatga catcgtgtga catggtgtga tgtcctatca 20460
cagtgtgaca tccctggtgt gatgtggtgt gacatggtgg gatgtggtgt gacatggtgt 20520
gatgtccctg gtgtgaggtg gtgttggaca tagtgtgatg tgatgcgaca gatgtaacat 20580
ccctggtgtg atttggtgtg acgtagtgtg atgggtatga catccctggc ttgatgaggt 20640
ataatatgaa atgatgtgga atggtgtgac atgatgtgat gtgatgggac agggtgtgac 20700
gtccctggtg tgatgtgatg taacaggctg tgacatagtg tgatgtgggt ggtgtgacat 20760
gatgtgatgt ggtgtgatgg tgtgggacat ccctggtgtg atggggtgtg attaaacctt 20820
gattccatgc agcacatgtt tctgtgagca cagggttggg gctaaagtta caggttaaca 20880
gcatctcaaa gcagaacaat ttttctttgt acagatcaaa atggagtttc ttatgtgttc 20940
cttttctaca taggcacagt aacagtctga tctttctttt ccccacagtg tgacatggtg 21000
tgacatttct ggtgtgactc ttgtgttgtg acatttgtgg tcaccccagg atacagaggt 21060
ctctgtggcc aagggaaggg ggagaatgga accatctgag catgttgacc tggaggaatt 21120
ggtggccctt gagtccacga agcccaccct tccaggtgcc cctgccccac gtgacccaag 21180
tgggcttgca gagcagcaag caggactctg gttagacagg aggaaggacc tgccaccacg 21240
tggccttgtg aggagacaga gcgaggctgt gacctcggcg tccgcccagc acagggtgct 21300
gctgaagctc ctccggtcct ctcagcagcg gtctcagagc aaggcccaag gcaggctgaa 21360
gagaggggca gagggaggat gctggggagg caggtgtgag gggactgaga gcccaggttt 21420
cagctgagcc cctccacagg gaaggagcct agctgaacac ccatctcccc acacgctccc 21480
aaccctgcct ctgcccgacc acctcccaga gggcacctcg aaccctctgc tacccacact 21540
cagcaagggg tatggtgccc ccaccaagcc cagccagcaa agcctggcac agccacgcct 21600
gtgcccacca ctcccatggc caaggtcact gctaacatgg caggacagag ccaggcctgg 21660
aggagacaga acatcagtcc catggggaag ctccctgctc acacggcagg gccaggcctg 21720
gagaagacag aacaccccat ctggcatggt actcaggctg cacatgcctg ccacgaacgg 21780
gggccacgcg acaatgcctg ccacacatgg gggccacgca acgatgcctg ccacacatgg 21840
gggccacgcg acgatgcctg ccacacatgg gggccacgcg acgatgcctg ccacgcatgg 21900
gggacacgtg acacacacat acacacacgg gcctcacagg cacacaaatg cttgcgaacc 21960
cagcacccac ccagcacact caggcatagg ctccctgggc aggtcacaac ctcacgcctt 22020
gagctagtcc atgtgccagg cccgtcaccc acgtactcgt ccccggtgct agctattgag 22080
ccacaccgtc ttctctgtgg atccctccca gcccactcag cacaatggac atgctctctc 22140
ccgtccagtg actgcaccgg cctcttcccc tcagcaccca agtctggcca tctcccagga 22200
aacccggacc accacgggca gggaccacgt tcctcactgt ccacgtggac caccccacac 22260
ctgaccccag atgcagtcac actacgtcct gcttcaatat tgaaaagggg aaaagctgga 22320
ggagggtaaa gatgaaagag aaaaaagcaa gaggggaggg tcacattctt ctgaggcttt 22380
gattacatct cactgagccc ccacgttgca tgaaaaggag gggtggaggg agcaattaca 22440
catttgcctt gtgctcagta aatctgcact ttataagcaa ataaacagag tagaggaaga 22500
agtcaaatat gcattcgtct caggggcagg agggatgatt tcttgtctca ttttgtccca 22560
tgtcatgaag accgggctgt taatttatat tgtcagggtg agggaggcca cctgggtaga 22620
cctggcctat ctgctgctgc tctcagtttg gaaacaaaag gaaacgcatg actttttttt 22680
tttttttcat gactcagctt cccacctcaa ctgttctttt tggcatagtg actttagggt 22740
cctgagattt tattttcctt tcacaatggt caagatcaca ccctcagtat tcaggagagc 22800
tggtccaacc cagacccctg ccgtccctgg acgcttttca aatacgtgct gcagtctctg 22860
acactctctc accatggtag aaactgaggt cttggtgagt ctgcagcccc tgctcatggg 22920
gacaatgcag gctgaaaccc gcatttctga ccccaaagct cctgttcctt tcactcaccc 22980
ccacaccagc tctttgagtc cagagctttg tccttgcctg agtcctaccc tcagggacag 23040
gggcccaacc cagccaccaa cacatcatac cctgagaggg tgccaggagc ccagagatgt 23100
ttggagagca cagtagccct ggaagctctg tggagatgct gcacatttct ctattcaaca 23160
gatactcgcc aggtggccag cagcagagat gccacatggc atggagctcg ccttggccaa 23220
caggacaggt gtggggttgg gaggccttcc cagggcactc cttgaagcag agctgtgggg 23280
aaaagttggg gccaatctca gatctccccg tcaacaccgg gtctcctgcc ctcctgggcc 23340
acagaaaact aagctccgtg gatactgcgg ctgggtgggg ccgtggggga gaagaaatca 23400
caacgagtta aaagatcatt ttctaaaact gttatgatca ggactcacat aaccatatga 23460
cgacacattt cagagatgct ctttatctca ttaattaagg tgtcgtaacc agttcaaagt 23520
ggaattctaa gtactacact tacataattg attcaggaat gctaaaagga gttcatagat 23580
agatgcaaaa ctggcctttt ccctggaaga tgaggagcaa ttcattgtcc ttccaaagat 23640
gagaacttga atttctacca actcaaagag cttttgcatt gctatcaatt atgtacaact 23700
tagagcagtg gtccccaaca tttttggcac caggaaccag ttccatggaa gacaattttt 23760
ccacagacca ggatcggggg atggcttggg gacaaagctg ttccacctca gatcattagg 23820
cattagggtg tcataaggag tgtgcaactt agatcccggg aatgtgcggc tcgcaatagg 23880
gttcgctcct gtgagaatct aatgctgcca ctgatctgac aggaggtgga gctcgggcag 23940
gaatgctcac acacccctca cctcctgctc tgtggcccag ttcctaacag gccatgaacc 24000
ggttccagtg catgacccag ggattgggga cccctggctt atagaggtgt aaaatagttc 24060
aaaggaaata aaagatgcag agctccacag aatgaaataa cctggaagag tgtacaagac 24120
gatgccttgc tttccatgga aggcacctac taatttttct caatgtttcc tataaacata 24180
tataactgac tgacagaaac agatccataa tataaagaag acccctgtaa accaatgaga 24240
aaaaaaatca aataatccaa cgaggaatag gcaagagaat tgaacagatg ttttacagaa 24300
gatatccaaa tagccactaa acatatgaaa aggtgttgaa ccacactagt caacagggaa 24360
atgaaaatga aaaaccacat gagagaaagt agttctgatt ccagtaatgc tagagcagct 24420
aatatcagac tagccctttg gcagatggca attataaaca ctggaaacac tgtaagcaca 24480
cacaacaccc acacacacca attgcaggca ctggaacatg accagaagta ggcaaacact 24540
agtaaggatt attccgtgaa atattcgtct gaagtcacac cccagtgcat gtaatgggtg 24600
cagctagagt ttaagcagga aactgcagcc ctcctggtga ggagtgggat gcagggctgc 24660
attttcagag cagctggaaa tgaagagaag atgtccataa aggagaagct caccgaaggg 24720
aaaccacaca atctgcaagt aaactccact gaaacctctg gccgatccct taggtgtgca 24780
tgggtaggga aaactccaaa gggcccagca gaaagcaaca cctgtaagtc gagagaactg 24840
agattccagc tactgccaac tgccaggcag acagacttgg gagtttgagt caactcaagc 24900
taactgctaa cattgaaaaa aacaattaat gctctgctaa gaaagaatgc aaaccccata 24960
gcctgtacgc atgttatcaa catcaggtgc acatccaaaa ttaccatgga tgcaaagaaa 25020
catgaaaatg tgatccatag tcagaagaaa aagggatcaa tggagatcaa ctccaagatg 25080
acctagatgc agatacagtt atcagacaag gactttaaag aagttatgtt aaacatgttc 25140
aaagacttaa aggaaaatac tattataatg agtgactaga tggggaatct ctataagaga 25200
cggaaaatat ttacaagaac caaatgaaaa ttctagaact gaaagtatga ttctgaaatg 25260
aaaaacatca tttttcagag cagggtgaga atggacatgg gactcagagc tgagcaggcc 25320
tggtgggccc caggagggag acacagagga ctgggggatt tcaaggctgg cagaggccag 25380
agatggatcc ccagctggga ctggacctgg gcttatggga gcaacaggtg acccatcctc 25440
cttcctgggg gcccaccctg cccggcccct ccagcccagc acaggcattg gatagaaccg 25500
ggagagagca ggccaggcac tgaggcctct gccccaaatg cccacagcct ggggaaaatg 25560
agcagataga tgggggggca agtggatccc caggcacacc cacacagtgc acacagcccc 25620
acctgggcca gagggggcag gaggctcgcc acccctgctg tggtttctcc cacacttgat 25680
gcaggtgata ttcctctgag attgtggact aagagttggt gctggaaggg gttagccatc 25740
ttggagatgt tgctatgggg tgcagggatt ttgcatgtga gaaggacatg attatggggg 25800
gagcggaggg caaactgttg tgggttaaaa tgtgtcccct ataaattcat gtgttgaagt 25860
cctaaccccc aggaccacag aatgtgacct tgtttggaaa cagtctttgc aactgcaatc 25920
aagttcagat gaggtcaccc tggagtaggg caagcctctg atccaatatg actgctgtcc 25980
tcatgaaaag ggggaatctg ggtacagaca gcacgtgggg agaacaccct gtgaagatgg 26040
tgctgcttcc ataagccaag agcagcagag acggccggca aagcccagca gcaaggagag 26100
agcctgggac agagtctccc atgacacaga ggtgccagcc ccgccgaggc ctccatccca 26160
gatgcccggc ctccagaacc aggacggaat aaacgtctgt tgtttaagcc acgcagtctg 26220
gggtgctgtg ttgccagggc cacagttaac ggatacgagt gttgtcctga gctgccagcc 26280
ccacaggctg cacgaggcct ccctgcccca gcccagtgca gactccccag ccccctgggt 26340
gtgccatggg cagtgcgggg cccctcactg catcctcccc cagcctggga ggttgagccc 26400
attatgagct ccatggggtg aagccggagc cagaagctgg gagccgactg ggagcctgcg 26460
gctggaggat ggatttcccc agggacccac acgtgcacct ccacctgtct cctggacatt 26520
ctctctgagg gcagggctgg tgtcagctca gggatccagc agggacacaa gggtgggccg 26580
ggtccttgtg gagagcacat ttagtgggag ggacatgatt tcccttcaaa gtgcccattc 26640
tggatgcttc ctggtccacg ctggacactt cctgttccac gctggacgct tcctgttcca 26700
cgctggacgc ttcctgttcc acgcttgatg tttcctgttc catgctggat gcttcctgtt 26760
ccatgctgga catttcctgt tccactctgg atgctccctg ttccattctg gatgcttcct 26820
gttccatgct ggacatttcc tgttccactc tgcatgcttc ctgttccact ctggatgctt 26880
cctgtgcgaa acctcctcgg gcttttggtc tgcccagtcc ctctggctgc atctcgtccc 26940
ccgctacctc ccacctccac atccgtcctt gcccagctcc tctctctctc cagagtttcc 27000
acctggcaag gtccctgatg agctcagtcc aggctccccc agcacaggta ggagcctagc 27060
acctgccctt ggacctcccc accctgcatg atgccagcat ccccaggccc cagggaggcc 27120
ccatttctct ctctactgct ggcccagtgg ccctggagtc ccactgcaac tcgggtgtgc 27180
ccctgacctc tgaggaagtt aagtgtcctg tccctagcca ggctatcccc tctgctcagc 27240
cccagggccc tgccccttac cccttcccct cacctgcacg ataggctctg gccaactctg 27300
cccaggccct gaatgggccc ctctggctcc cctctgctgc tacactgccc tgcaccacct 27360
ccactcagct tcagtgtgtt catccacctg tcccaagtcc cctcggcccc caggagcaca 27420
gctggtggcc ctggttcctg gcagcccatc ttgttccttc tggagcacca gcctcagagg 27480
ccttcctgtg cagggtccac tcggccagcc ctgggaccct cctggtctca agcacacgtt 27540
ctccctgcag ccagacctgc ccctgcctgt gagctcagac ctgagccttg gaacgtcttc 27600
ccttctccat cccagctcgc ctttgccagc tgctcagtgg gatgaactca cactcccctc 27660
cctccaccat gagtgagagt cagctggaga gatgcccagg ccaaagcagc caccagggcc 27720
cagtgggggg ccagaagctt caggtgagag gcccaggtat tgagaggctg agaccatggg 27780
cagaatggtc ataatcgctg ccagtctcag tccagcccca gggactcaga gacagagaaa 27840
agagcagcac acaaggtccg ggctccccac cttctcccgt gagtatgggg gagtatgggg 27900
gcagccacca cccccatccc cacacaccca tgaggcagcc tcggctctgt gtggactccc 27960
cctcgccctc tgacacagaa accaccagaa gaaaagggaa cttcaggaag taaggggtgc 28020
cgctggtttc aatcctgttc ttagtctttg cagcgtggag ttcacacccc tggggacctg 28080
ggacctgagc tgtgatttcc taggaagaca aatagcggct gacggcgggg gcggggccgc 28140
ccacatgtac ctcgccagaa caggaagggt tgagaccccc acctcggtga gtggggtcag 28200
cacagggcag gggcacaggc tcgggaggag gacagcctgg gcgcagccgt cggcgctcct 28260
agacctgagc tgctgaacag gctgcaagag gctggggaga cgcgggcgcg aggccagccc 28320
cacatggaag cccaagcgga gccagcacgg gggaggtggg cagccttcag gcactgatgc 28380
ccacccagtg cgagacgacg gggaccgtgg gcaggggctt ccaagccaac agggcaggac 28440
acaccagagg ctgactgagg cctccaggac gaccgggctg ggagcacgag gaacatgacg 28500
ggatgcggca gaaccggctg tggggtgatg ccaggatggg cacgaccgac ctgagctcag 28560
gaggcagcag agcgagggag gaggagaggc cccaggtgaa cggaggggct tgtccaggcc 28620
ggcagcatca ccagagccca gggcagggtc agcagagctg gccgtagggc cctcctctca 28680
gccaggacca aggacagcag gtgagccggg agcagagcag cgagggtgag tgtggcagca 28740
ggacagaagg gtggaagcca aggagcccag aggcagaggc agggacaggg gagggacagg 28800
ggctgggctc agagccagct gatggggctg gggcacctgc tggcggggag cagggctgtg 28860
gtcagcagcg gagaggaggg gagagctgtg ctgagtgcac gggcgggagg agggaagagt 28920
ccagggaggc ccagaaaggc ccagagtgca gcaggcctgg ggcgagggga ggggctgagg 28980
cccagcagag cagaggccac tgaggagctg aggttccgga gaggcttcca gagcaggagc 29040
agtgcaggga cgggaggatc cgggagctca tccaggaggg gcacataggc aaggggctct 29100
gttggggaga cctgactgga cactggggct gctccacagc atagggaaca agccaagtgc 29160
tgcaaaaaca aaaatgaggc cagaaaaaca gcccaaacct ggacagaggg tgccaggaca 29220
ggcagggggg caacagtggc ctgagtgaca ttgctgcccc gggttgaggg aggacagagt 29280
gagcaggggg caggcattgg agttcagggt accaggaccg agcagccaca ggtgagcagg 29340
gcaggtgggg gtagaaggag cagggggcag ctcctggaac tcaggggacc agggcagagc 29400
agccacaggc aaacaggaga ggggaggggg ggcaggagga gcagggggca gctcttggag 29460
ctcaggggac cagggcagag acgccgcagg tgagcagggg caggtggggg ggcaggagga 29520
gcagggggca gctcttggag ctcaggggac cagggcagag cagccacagg tgagcagggg 29580
caggtggggg gcagaaggag tagggggcag ctcttggagc tcagaggacc agggcagagc 29640
agccacaggg gaggaggggc aggtgggagg caggatgaac agggggcggc tcctggaact 29700
caggaaacag gggagagcat cagaaggtga gcagggccag tgggaggttg cagagcaggg 29760
gacagctcct ggagctcagg ggaccagggc agagccgccg caggtgagca ggggcaggtg 29820
gggggcagga ggagcagggg gcacctcctg gagctcaggc gaccggggca gagcagcctc 29880
aggtgaaaag ggccggtggg gggcaggagg agcaaggggc agctcctgga ggtcagggga 29940
ccagggcaga gccgccgcag gtcagcaggg ccggtgggag gcaggacgag caggggacag 30000
gcactagagc tcagggcaag gcagccacag gtgagcaggg ctggtgggag gcatcactca 30060
gctcctagac tttggcagga gctgggtagt tgccggcagc agacagctga gagctggtga 30120
aagtgcagtg cagcctcctg gtgccgggaa gggagtgtga gtccatccca ctgagcagtt 30180
ggcaagggcg agctgggatg gagaagggaa ggcattccag ggctcagggc tgggctctca 30240
ggcaggggca ggtgtggctg cagggggaac gtgtgcttga gaccaggagg gtcccagggc 30300
tggccccagc ggaccctggg caggaaggcc tctgaggctg gcgccccaga aggagcaaga 30360
tgggctgcca ggagccagga ccatcagcac aatgaagctg agtggaggtg gtgcagggca 30420
gtgtagcagc agagggctgc cagaggggcc cattcagggc ctgggcagag tcagccagag 30480
cctgtggtgc aggtgagggg aaggggtggt gagcggggcc ctggggccga gcagagggga 30540
tggcctggct gagggcaggg cgcttagcct cctcagaggt caggggcaca ccccacctgc 30600
agtgggactc cagggccact gggccagcgg cagagagaaa tggggcctcc ctgtggcctg 30660
ggggtcctgg caccatgcag ggtggggagg gccaagggca ggtgcaaggc tcctacctgt 30720
gctggggggc ctgggttgag cccagcaggg accttgccgg gggaagctct ggagagaggg 30780
aggaggtggg ctggtggccg agaaggccag gccagggctg ggagggtgag gttgtggtga 30840
ctgagcctcc agaagtaatg caggacactg ggaggcaggg ggcatccagg cactcagggc 30900
cctgacctgg gctgctgcac actggggcta aggggaaagg aggggagagg ctgaggagga 30960
ggctccagga ggctattcca aggcaggggg ttccggggcc ctggggctga agggcgccga 31020
ccctatgcag tgtctggccc ctctgctgca cagaagaaaa gggccttgga gggcagaggg 31080
caggctatga ccagggccct gggcaagtca ggcccactca ctagcggagg gccacgctgg 31140
ggcggcaggg tcaggagctt caggggactc gggggaccca cgagaagcca tctgagaaca 31200
gtgtccactg gtcaagccag gcacccataa aaggctggag tggggccaat gggcatgagc 31260
cgtccctgag gtggcaccga tggccagagc tgaggccaag ctagagacac tggactgtgc 31320
tgactcccgg caggcacaga gcgctgacct ggctgccgag ccccgccccc taggctgcag 31380
gggtgcctgc agaagggcac cacagggcca ccggtcctgc aagctttctg gggcaggccg 31440
ggcctgactt tggctggggg cagggagggg gctaaggtga cgcaggtggc gccagccagg 31500
cgcacaccca atgcccgtga gcccagacac tggaccctgc atggaccatc gcagatagac 31560
aagaaccgag gggcctctgc gccctgggcc cagctctgtc ccacaccgcg gtcacatggc 31620
accacctctc ttgcagcttc caccaagggc ccatcggtct tccccctggc gccctgctcc 31680
aggagcacct ccgagagcac agccgccctg ggctgcctgg tcaaggacta cttccccgaa 31740
ccggtgacgg tgtcgtggaa ctcaggcgcc ctgaccagcg gcgtgcacac cttcccggct 31800
gtcctacagt cctcaggact ctactccctc agcagcgtgg tgaccgtgcc ctccagcagc 31860
ttgggcacga agacctacac ctgcaacgta gatcacaagc ccagcaacac caaggtggac 31920
aagagagttg gtgagaggcc agcacaggga gggagggtgt ctgctggaag ccaggctcag 31980
ccctcctgcc tggacgcacc ccggctgtgc agccccagcc cagggcagca aggcaggccc 32040
catctgtctc ctcacccgga ggcctctgac caccccactc atgctcaggg agagggtctt 32100
ctggattttt ccaccaggct ccgggcagcc acaggctgga tgcccctacc ccaggccctg 32160
cgcatacagg ggcaggtgct gcgctcagac ctgccaagag ccatatccgg gaggaccctg 32220
cccctgacct 32230
<210> 77
<211> 340
<212> PRT
<213> Intelligent
<400> 77
Ala Ser Pro Thr Ser Pro Lys Val Phe Pro Leu Ser Leu Asp Ser Thr
1 5 10 15
Pro Gln Asp Gly Asn Val Val Val Ala Cys Leu Val Gln Gly Phe Phe
20 25 30
Pro Gln Glu Pro Leu Ser Val Thr Trp Ser Glu Ser Gly Gln Asn Val
35 40 45
Thr Ala Arg Asn Phe Pro Pro Ser Gln Asp Ala Ser Gly Asp Leu Tyr
50 55 60
Thr Thr Ser Ser Gln Leu Thr Leu Pro Ala Thr Gln Cys Pro Asp Gly
65 70 75 80
Lys Ser Val Thr Cys His Val Lys His Tyr Thr Asn Ser Ser Gln Asp
85 90 95
Val Thr Val Pro Cys Arg Val Pro Pro Pro Pro Pro Cys Cys His Pro
100 105 110
Arg Leu Ser Leu His Arg Pro Ala Leu Glu Asp Leu Leu Leu Gly Ser
115 120 125
Glu Ala Asn Leu Thr Cys Thr Leu Thr Gly Leu Arg Asp Ala Ser Gly
130 135 140
Ala Thr Phe Thr Trp Thr Pro Ser Ser Gly Lys Ser Ala Val Gln Gly
145 150 155 160
Pro Pro Glu Arg Asp Leu Cys Gly Cys Tyr Ser Val Ser Ser Val Leu
165 170 175
Pro Gly Cys Ala Gln Pro Trp Asn His Gly Glu Thr Phe Thr Cys Thr
180 185 190
Ala Ala His Pro Glu Leu Lys Thr Pro Leu Thr Ala Asn Ile Thr Lys
195 200 205
Ser Gly Asn Thr Phe Arg Pro Glu Val His Leu Leu Pro Pro Pro Ser
210 215 220
Glu Glu Leu Ala Leu Asn Glu Leu Val Thr Leu Thr Cys Leu Ala Arg
225 230 235 240
Gly Phe Ser Pro Lys Asp Val Leu Val Arg Trp Leu Gln Gly Ser Gln
245 250 255
Glu Leu Pro Arg Glu Lys Tyr Leu Thr Trp Ala Ser Arg Gln Glu Pro
260 265 270
Ser Gln Gly Thr Thr Thr Tyr Ala Val Thr Ser Ile Leu Arg Val Ala
275 280 285
Ala Glu Asp Trp Lys Lys Gly Glu Thr Phe Ser Cys Met Val Gly His
290 295 300
Glu Ala Leu Pro Leu Ala Phe Thr Gln Lys Thr Ile Asp Arg Met Ala
305 310 315 320
Gly Lys Pro Thr His Ile Asn Val Ser Val Val Met Ala Glu Ala Asp
325 330 335
Gly Thr Cys Tyr
340
<210> 78
<211> 427
<212> DNA
<213> Intelligent people
<400> 78
acaacaggca ggcaggggca gcaagatggt gttgcagacc caggtcttca tttctctgtt 60
gctctggatc tctggcgcct acggggacat cgtgatgacc cagtctccag actccctggc 120
tgtgtctctg ggcgagaggg ccaccatcaa ctgcaagtcc agccagagta ttttatacag 180
ctccgacaat aagaactact tagcttggta ccagcagaaa ccaggacagc ctcctaagtt 240
gctcatttac tgggcatcta cccgggaatc cggggtccct gaccgattca gtggcagcgg 300
gtctgggaca gatttcactc tcaccatcag cagcctgcag gctgaagatg tggcagttta 360
ttactgtcaa caatattata atttaccgtg gacgttcggc caagggacca aggtggaaat 420
caaacga 427
<210> 79
<211> 121
<212> PRT
<213> Intelligent
<400> 79
Met Val Leu Gln Thr Gln Val Phe Ile Ser Leu Leu Leu Trp Ile Ser
1 5 10 15
Gly Ala Tyr Gly Asp Ile Val Met Thr Gln Ser Pro Asp Ser Leu Ala
20 25 30
Val Ser Leu Gly Glu Arg Ala Thr Ile Asn Cys Lys Ser Ser Gln Ser
35 40 45
Val Leu Tyr Ser Ser Asn Asn Lys Asn Tyr Leu Ala Trp Tyr Gln Gln
50 55 60
Lys Pro Gly Gln Pro Pro Lys Leu Leu Ile Tyr Trp Ala Ser Thr Arg
65 70 75 80
Glu Ser Gly Val Pro Asp Arg Phe Ser Gly Ser Gly Ser Gly Thr Asp
85 90 95
Phe Thr Leu Thr Ile Ser Ser Leu Gln Ala Glu Asp Val Ala Val Tyr
100 105 110
Tyr Cys Gln Gln Tyr Tyr Ser Thr Pro
115 120
<210> 80
<211> 32230
<212> DNA
<213> Intelligent people
<400> 80
gaattcctgt ttctagtagg gacagaaacg gaacccaggc tgttctggcc aatcatgccc 60
tatctcagaa tgttacattt ccagaacatt ctacagttat tccagaaaac tacaatcaag 120
aaagggaagg ggactgggtt gattcaagac aaaatgaaaa ctattctgca aataccatag 180
tgaaatcaca gctcagtaat ctttttgtga ctggcttatt tcatttagcg taatgtcctc 240
tagtttcatc catgttatag catgtgtgag aatttccctt tttaaagcta aataatatgc 300
tattgtatgt atatatcaca tttggattac cagttcactc ctttgtgaac atttgagttg 360
ctctacctgt tggctactat gaataattcg gttctgaatg tgggtataca aatatctcct 420
caagttaatg tcttcaatta cttgggtata tgtccaaaag tggaattgct ggattatata 480
gtatttccat tattaattct tcgaggaatt gccatctggt ttcccacagc aggtgggcca 540
tttacatcac cacgacagtg tccacaggag ttccagttcc ctaagttctc accatgactg 600
gtcattttct gttggaaaaa aaaatcctaa taggtgtgag gtgggttttg tttttatttt 660
tctaaggatt aataatatta agcatctttt cctatgctag ttatctaatt atctctaaag 720
aatattctcc agagaaatgt cgattcatat acttttctcg tttttaatca ggtattttat 780
tttaatgttg acatgtagga cttattttta tgtactagat attattaacc ccttatcaga 840
tatacgattt acaaatattt tcttctattc cacatgttgc attttcactg tgttggttat 900
gtcttttgat gcccatttta catttttatg tagtccaatt tatcttcttt tctacttttg 960
cctgtattat ggtattaaag gtgttagtat tcaaatgtct ataaatactg acttactatg 1020
ctgagaaggt cactctagac catctctctg atggtggagc taagaatttt acactctctc 1080
attttgtacc agggcacagt gcagctaggt gagaacacag tggctttctc gagcttattt 1140
gtcttgcatt tttggcgaca aggattgttg ttcacattgg cctcctctgg caggtccacc 1200
tggaaagcat tatatttagc aagaaaaaag gaggctgtga atgatgtcaa ctgtgtatat 1260
tccctgttgc aagtgtcaaa tccatgaagc ataaaaggat ttactagagg atattaaatt 1320
ccttgcaaag tgttgaaaaa cctgaaggaa taggctccag gcaaagcctc tagaacaatt 1380
ccaagaatgg cactgctggc gcaggctggg gaggagctcc tgctgcctga gactccacat 1440
tcaagctgtc tcctgcagga aagagagcag ctcttctcac tactgccccc tgaaggacag 1500
cagctctgct atcaactact agagacctga cccctttccc tgcagccctg cctgtgttga 1560
ttatatcttc atgtcagact catgtagatt catctgtttt caagggtaca ggggttattt 1620
ctgcccaagt ccacactgtg gctttctatc ataaatacac gtttctacac ttgaatttcc 1680
aggaattact agtatcaaca gcaaaatgct acaacccaac ataaagattt cctttacaaa 1740
gaacatcatg ctccccatgt agcattgtgc tccccaaaat gtggggaaac tccaatctgt 1800
tcatcccaac accatctagg aaaaaatgtt cttctctcat gagccattaa tctgtctact 1860
tattgtttaa tttttggcct aaattgtaaa ggtggctaaa aatagcactt tgaatttttt 1920
taaagaaagg gtatatagaa aatattaaat tatttaaaat acatatatgc atgacacatt 1980
tagttattgt caccagcttc tttcacattt attttattct gtagtttctg gcaatacttt 2040
ctctatggta gagtctggaa atgctactcc tcatgtcctt ggcttcctaa gtcccagatg 2100
tggtgaagaa tgcacatcag ctgtgttact acagaatgct tttggattga gatgggggag 2160
gggacgtgct tgatctcact caaatgtgct caatttcctg gtctgggtca cagccaggca 2220
gcccagtcct atgggcacaa tatcttcact cgccaggttt ctatcaaaat gagagtgtcc 2280
ttcttgactg tggaaaacac ggggcaggga gaggatcaag aaatagcaaa aggagtattt 2340
ggacttgcct gagctgccac tctggtttcc ccaaatgttt tcattccatt tcattcatga 2400
taataaacac ctttctgcct aaccagccat aatcactttt cttagatcca gctgattcag 2460
tgataaaact aaagggaaaa aataaataca gttttcaacg tttaagctga ccaggtggct 2520
gtctctggtg tttatacctc catatcccac tatgcatttc atcttctctt tgcctcactg 2580
gagatccaag tgcagggaat gcttcacgtg actgtgatcc ctagaacttc atcttcatga 2640
ctgttgaaat cttctctgag ttttaccagt ggaaatggca ataaatagaa agattccaga 2700
aggtccccta gggtccatat tttctgtact tcttctctaa aataagtaaa atcaattcca 2760
tttgctcttg ctttatattg gctacatcta tgtgcccagg acacacccta aagccctgtg 2820
ttgacaactt atccagtatt gtattaagtc taaatggtca catgcttatc atatcatttc 2880
ttccaatttc atggaataat tgtcatgtca actctttgga ttaagaacca tcaaccagat 2940
aaccacagcc ctgaataaat agaaacagaa tatttcaagc tgttcagttg gcataacagt 3000
gatgagtcta tagctcattt tcaagatata aatattctat ttatgggagt aaaagcacga 3060
atcatggtta gtgtttcaga gcctccacca catctgacag catagcaatt caacagcaca 3120
aggtttgtgt gccagctgtg cctgactaat aatgtttttt tcccctgtct atagggaaat 3180
ctgcacctgt gcacatgaca agagcatgag ctacactttt ttcacttttt ctgaggtaaa 3240
tacattgctt gatccaaaac cgtattatgg aataatttcc tgactctgat gaaagcattt 3300
ggaaaatcct caaataatat ttgtgcagaa atacaaccaa aaagaaaggc aaattcatat 3360
ataggaaaat aaccagtgct ctcctcatgt tacatgaggt ccactagtat cacctgaccc 3420
cagctgttca tctgatccct gatgtgttgt acaatgttag gggttcagga ggggtcattc 3480
ttcttggcaa atgaggtgtt cagaagagcc agtagccctt taagtctcag ttagttgaaa 3540
ttcataattg agtccccaaa gggacctcca taacattggt tcatgagact ccctggtaaa 3600
gctgggaaag gtgactgact gaagtccatg tgttgaatca tcctcattat taaaagcccc 3660
tgctcattaa tagcattttg attaatattc actgggaaag catttttttt ttattttggc 3720
tcatctttga aaagtctagt catagctttt caatcacttt gtctgcaatc gttttgttgc 3780
atttctttga aggcctgatg atctgtcaaa accaacagcc aatattatta cattgccgtt 3840
atgttgggaa aagctgaatg ttgggagaag ctgaggcagg gcttgcatgt ctgacgtaat 3900
gtaaaagagt cttggaacac gtccggggtc cagggtctaa aaccccttgt ggcctttagt 3960
acaccaagct ctgtgctaaa gggtggaagg ctaccctgac gcaccataat ctaagcccag 4020
ggcataaaat cccttgtgac ttggatagaa tccaggactc gtggctctgg agtgtgtcta 4080
cacttgctgg ctcctttctc tttgctctcc aaggatcgat tgtatcttga gttaaaagaa 4140
cctgctctcc attatctcaa gtagtagagc aaatgctaaa ccatcacagg tgtaaatcat 4200
gtgcttaatg caatgcatcc ttttggcctc cacattctta ccacgtgttt ctttgttgga 4260
ttaccaataa atagcatggg atcccagggc tcagggcctt cttagcctcc atacactacg 4320
atggtccctg gtgcccacat ttctctctca aactgtcttt ttctcaatct ttgactccac 4380
cagactttgt cacccccacg acctggtgtt gggtctgatc accccaaaac tgttatcgtt 4440
gcaatgtgat catcagatat aacccttgca gtttactcat tgttatgatt tttacatttg 4500
cagggcttcc ttgacaatgg cactaatgtg acgccatcca gcatccatta ttgtgagaac 4560
tctatttgga atatcaccat tgtgggcatg aacagaatgg agactttcat aggatgcaat 4620
gtttaatatt caacattagt caaaatttgt tctagtccta cccttggagc tccattgagt 4680
tggaaaaata taaataaatt tattttaaat ataatataaa tgtaaatata aacaaattta 4740
aatataatat aaatataata taaatataca taaatttaaa cataatataa atataaatat 4800
aaataaataa ataaacaaaa aaattttctg tagcaagagt aagaactaca tgtggtccag 4860
aataccatta ttttatggaa ggttacaaaa aattttaaat gtatttaatt cagataagaa 4920
ttttataaat atgcatatat tgcatatatg atagaataaa tgtacttaaa tatgaatact 4980
atatatattt gtagccaaca ttttatcaaa aacatatata ttcacttcta tgtatcttat 5040
atacatgtat gcatactttt ccgtaagata aattttaatt ttttattgaa atactaatta 5100
gttttaattt tgtctttaat tttcttttaa taacttcata atttgattac tggatattca 5160
catttaaatc accaatttaa gaaaaaatac atgtgtgtac atataggtag aggtgtaaat 5220
actgtatcag gaagctttta tgcattactg attggtaact ggttaaatac acaactcagt 5280
gactgataac agtaaacatt tgttttcatg ttcacggatg ctcatgttca caatcctctg 5340
actgatcaag gaagggctca gctgagtgga tcctctgaag gacacagacc tcatcttcag 5400
cctatagata tcaattgtct gaggactaag ctgaacacca gtgactacac atgatacaag 5460
attcttgtgg caggtcacag gagtgaacat cccaaaccaa actggacagt tgaatttaag 5520
tccaataatt tctaacatag cttcagatat ttaaaatata ttcctttatt tcagtgagta 5580
caaattttca agaaaatgtt tactccattt aattatagag gtgtttgatc attccatgga 5640
caaataatta tgttttcatc ctttacaatc ttgaaaatat ttgcaaatgt aaatttgcat 5700
taataagaaa ataaagctgg atgtgttttc aacatgtggc tttaaatata attttttaaa 5760
atggcctcat tgggggaaaa tcattttaac ttatatgaat atcctttttt gcctctcttg 5820
tgttctatag agtggcccaa taagaggtcc tcccatgaga tttggaatca ggaaaggatg 5880
gctcaatatt ctccattggt acctaggaca gacacaggga cagagatgag gactggagaa 5940
acacctggaa agatgctgta ggaagctgag agcatcagca cccccacccc taagcttcca 6000
gacaggactg aggaccacat ggttagatag cccatacttc aggggaagat gcattcagtt 6060
ttctgaggga gcaacagaga ttcctgcttc taatatcaac tttcctgact actatatcct 6120
tggctttgaa aggttgtagt gggaaagtta atcgtaggaa ttgggtcatt cttgtcatac 6180
ccaacagagc caagaaacca ggagggaaag acactcaggg tgcaaaatat tgtctgaaga 6240
atgtaattga aataggccct attatcccat ggaactaatg tttatggttt tttgaaggaa 6300
catagaaatt gactcctcca gtcttaaaaa ctcaagatag ttatattttt cttatctgag 6360
gagttctttt gtcaggaaac caaccatcag gcctccagat actatcaaaa ggagctgaaa 6420
cttacatatc actgaatcgg gacagtgaga catcagactc ttcacccatt gtgattgcct 6480
aactgacctc ctgcttcctg ttgaccaaat catcttcctt acccctccct aattcctgtt 6540
ttcccacatt tcttccctga tatatatacc cctcatttta gtagttcagg gagatacatt 6600
tgagaatggt gtcccatctc ctcggctgca gcacctgatt aaagcctgtt ccttggcaat 6660
acttgtctta gtgattgttt ttctgtgtgg tgagcagcag gatctacact gaatccctgg 6720
catttcagta acaaaattct ctgcaagctt cactgccttt ggcttattgt aacctgaaat 6780
caaatttatc cacaacttct gagataactt gatataactg taggattcac tttgtccacc 6840
actgcttccc agtctgagct tgccagctcc caacccttcc tagtgcccat gaactttctc 6900
aaagagccat aggtaacatg ttcccttttt cgtaaaactc taaccttctc tttgttcttc 6960
caacatattg aagaccactg agttttcctg tatgccccat ttggcaaata tttctttgca 7020
cgtaaaacat taaatttaga gattcatctc tacattttat ttagacttca gtagtttaga 7080
ctctaattgt ctgtattaag acaattcctg ctttgaatat ctatagtggc ctcttctctg 7140
ttatataaag tccagctgaa gccataaact agactcttca ggtgtcatga tctctgtctt 7200
tattaaatca ggagaggcat tgctagatct gtgcagttgg ggctgagaaa gagaaaagaa 7260
ttagggtgca gaggtgactc catgtccccc tctaccaaca ccatcagagt gtggctgcat 7320
ctgaggacca ctctcagctg atagaggcat caggaggagc agctggggca gccctgcctc 7380
acacatctgc ttccctgggg gtttatgttc gggtgtgtaa cactgtggga gaataactat 7440
tatactgttg gcagtaataa gttgcaaaat catcaggctg caggctgctg atggtgagag 7500
tgaattctgt cccagatcca ctgccgctga accttgatgg gaccccactt tctaaactag 7560
acgccttata gatcaggagc ttaggggctt tccctggttt ctgctgatac caggccaacc 7620
agctactaat actctgactg gcccggcaag tgatggtgac tctgtctcct acagatgcag 7680
acagggtgga aggagactgg gtcatctgga tgtcacattt ggcacctgag attggaaata 7740
gaaacacaaa tattcatact attgatcata ttataggaag acttccctga ataaccaggc 7800
agtactgagc acactgggct gagtaaattc ctagtgttct ccttccttac ctgggagcca 7860
gagcagcagg agccccagga gctgagcggg gaccctcatg tccatgctgt gtcctgactg 7920
ggtctgactc ctgcacaaag tgtgaccagc ctattaataa ggcttcaggg caggaggttg 7980
tgctctggga acatgcaaat gagcagggga tggggcaggc tgggcacagc tgcagagctg 8040
gctcatctca gtaactcagc accagctcag tgtccccagg tgtcccaggt aagaccaggg 8100
tagcacaaat ttgtctgcag agaatgtgtt tctactgggg actattttat tatgagaaac 8160
aatttttagg tatttttttg agaattttaa atattcctca ggagccgata gagtaatgta 8220
tttcattggt gtatcaggat tatttaggag aatattcttg tttgtaggaa acacatagta 8280
aaatgttaga tggtaggatt ctcaagtctt caaaagactc tcataagatt ccgggtaggg 8340
aagggggtaa ttgtgctata cctgcaacat ttctgtgagt ttaacattgt tcctttctaa 8400
aaaaaattaa aaataaaatg tatcggcatg atgctatata tttgtaagta ttaggtaatg 8460
gtgttatgcc tttgttctta ctagtattag atcaagcaat ttattacaga tatacaaaga 8520
tgataccgtg ttgtctccat gcatgcagca ctcacagatc caccactatc aagaactgca 8580
ggtctcttta atacccagag actaaatgag gtgcacctta ttcttgtttt gggtaccttc 8640
atagtctacc ttcttttctg ccattgggta ttatttccca aagttcatct gtcttagtga 8700
gggtggccac tgcacggagc atgtccctgc catgcaccat caatgacact ttcttcttat 8760
actttttatc agtgcatggg gacatcatcc tgacccagac accagcctcc ctgttaacac 8820
ctttaggaaa aacatactca atctcttatc aagcaattgt ctatgtacat ggagaaatca 8880
gttggatcca gatgaaactg gacatggatt tgcattcatt atatctcata tctctaatgt 8940
accctgaacg tcccagcctg actcagtagc aggggaagtg gatgtaacca catcagcatc 9000
agtgggctgc agcctcgggc tccacaaaat tttactgatg cctgactagg ggagcaaaat 9060
cacagtgctg cagcccatgc acaaacattt ctgctgcttt gtaagcagcc tgaattttaa 9120
gggaacttgc ttatattgga agaaaggaag aaagttccat ttgtcctcta aatgtttgct 9180
gaaaatgaac cgacaaaaga ataatgaata agagaaaagg caaacaaaat tcacttagag 9240
tgcggtggga tatcatagtg gggtgattac ccagataact caatgagatc cagttgttca 9300
tatttccttt ctagggaaga gggaattggg aagtgtaggc aacctggaga gaatagatga 9360
aaaaagaaat gcatcctcaa aagaacaggc aatagcctgc ctggataaag catcaacttg 9420
cagtctcttc tatttttgat tcatgttttg tgttaatctt ccctgatata aaatttccca 9480
ggaagaattt ccttgacaat tgtttttctt ctggagaatt tgcttttagg cagataaggg 9540
atatttagga aaagacttct tgtgcatttg ctgctttcta aatgcctttg gctttacata 9600
atcatcatac caatgcagca tagtttgaga tgttattttc tggattcctt tacttgcagc 9660
cacctgccaa gatcctgttt cagagagatg cagctgcaga ttgagtgagc agttgacccc 9720
tgaacaacat ggaggttggg gcactgacca caggtgcaga tgaaaacctg tgtagaagtt 9780
ttgcatttct aacttaagta ctaatagctt acttttgact ggaagcctta gtgataaaat 9840
aaatagttga ttacactttt ttacatttta tatatatttt atactctatt cttccaataa 9900
agtatggtaa agaaaaaaat gttcttaaga aaaccataaa aatgagaaaa tatatttact 9960
actgattaag tacttgcttt caggtgacac agaagaaaat ataagtgtat ctgcaaactt 10020
caaacccaag ttattcaagg gttaactgta ccatgatgaa tgtagcagtc cccatctgta 10080
gtctagggct ttctcctttg ctgtacctct gctcacttcc aatggccata tatatgtctt 10140
atgttcttta tgatcttggg cagagaggtc tgcctacatg cattgctggc cagatgtcct 10200
ggaatgtgta tctctgagga aagtgctatg gtttgactgt gtcctccaaa atccatctgt 10260
tgtaaagttc attctcagtg aaatggtttt tgccaggtgg gccctattgg gatgtgttta 10320
ggtcatgagg gtggagccct ctagtggaat acattaatgc cagtataaac agggtttata 10380
gggctggaat ctttctctct cttctgctgg tctgtcctga taagacatgg ccttccttcc 10440
attgaaggac tcaatgcccc aggcatcgtc ttgaaagcag agaaagctga ccttaacctg 10500
cccatgcctt gatctcaaac tttccgtact ccagaagtgt gagaaaatat atttctgttt 10560
tttatgaatt acacagcgac aaggaacctg ttatagcagc ttgaaagaga acaggagaga 10620
cagctcacaa tcagtgagga taagatgagg tatatacata tcccagcttt ctcatctctc 10680
aggtggaata gcccagagga atttagtcca tgtttccaca tgtggttgat cttcagttat 10740
cctgagtcag gtgggtggtt gatgtgtctt ttaccattca tcttctgctc ctgcctcact 10800
ttcttccttt cctcccagtg taaatttgct gcctaaacag gaatactcat tgctggtgga 10860
cccaaaataa gacagaaaaa aaaaatcatt gtacttttgt atgagggata tttctcatct 10920
gaattcttat cacttctctt tctttgacat ctaggaatat tcagaaaaca ctttttttta 10980
accaatctat tttagattga atttattgat tttttttcct gtgtgttttg tgaaccaaaa 11040
attaagttgt aagccaccaa cgagctaaat ggactcccct tttggcagag agaacttcaa 11100
agaaatctga aaaactaggt taggccatga ctggcaggtg ggtttggatg tgtctcatta 11160
tgctctcttc cctttggagt tcaggcacaa ctgaccagca ttatcattat aacagagatc 11220
tttggactga ggaaacagat gcttgtagca ataagatacc atactccaac atgacagata 11280
ataggccctg aagaaaatct aaaaatttta ctctaaaaat atttcttttt ctttttcttt 11340
tttttgtttt tttttgagat ggagtcgcgc tctgtgccca ggctggagag cagtggcgca 11400
atcttggctc actgcaagct ccgcctcctg agttcatgcc attctcctgc ctcagccttc 11460
caagcagctg gaactacagg tgcccaccac catgcccgac taattttttt tgtattttta 11520
gtagagatgg ggtttcaccc tgttagccag gatggtctcg atctcctgac ctcgtgatct 11580
acccacctcg gcctcccaaa gtgctgagat tacaggagtg agccaccgca cccaacctat 11640
ttctctgaaa tattctgaag tggccctgca aagctgcgcg ttgtgggaga aatttgcatt 11700
ctgtagagaa tctcctatgc ttactaatca ttttccaaag gtctgacttt ttttttttaa 11760
ggtctgacaa gcaacgtcta ctttttctgc tacccatagg attcatctac acgaaaagaa 11820
ccttggctta tctaaactca agcacacccc gttatctaaa ctcaagcatt tctttatggt 11880
gaattcaact ctttaggcag agcttaactc tttcaaccag ttgccaatca ggaaaacttt 11940
gaagccacct gtgacctgga agcccctgct tcaagatatc ccacctttcc agtacaaact 12000
aatgtatatc ttatatgtat tgatttatgt ctttgcctgt aatttctgtg tctccctaaa 12060
atgtataaaa ccaacgtgta atccaaccac cttgggcaca tgtttacagg accccctaag 12120
gctgtgtcac aggccataat ccttatcttt ggcaaaataa atctataact tgattgagac 12180
ctgtctcaga tactgttttg cttacactgg gtcacaaaat ttaaaaatcc tctaaaacta 12240
tctacacatc cataaatcta cattagaggc agtggagtga gcacactcca acagtcaaaa 12300
ctcacaagtt agaggaacct gagtctaaga ttttgtccag ctctcttgct tcataaaaat 12360
aatttgtgat ttttttaaat tttactctag agaaggacaa ttttggggaa tatgtttatg 12420
gtcagtggaa tgaataatgt ccccacccca aaagatgtcc atatcctcgt ctctggaacc 12480
catgttatac gagttattaa gaaactattt taggcatata gagaggaaac agggtccttg 12540
ggaaggtttt gtttctttta aagcagctcc agaaatgttt cttgtttagc aggaaagccc 12600
tggctcttag agctggtccg gcaagctttt ttttcttttt tagagaggga gtctcgctct 12660
gtagcccagg ctggagtgca gtggcacgat ctcggctcac tgcaagctcc gccctctggt 12720
ttcctcatgc ctcagcctcc caagtagctg ggactacagg cgcccgccac cacggccggc 12780
taattttttg tatttttcag tagagacggg gtttcactgt gttagccagg atggtctcga 12840
tctcctcacc tcctgatctg cccgcctcgg cctcccaaag tgctgggatt acaggcggca 12900
agctttgata tacaaatact ggccattaga aactgggtcc agccaaacat ggagattccc 12960
acattcttct tctttttttt tttttttttt tgagatggag tctcgctctg tcgcccaggc 13020
tggagtgcag tggaacgatc tcggctgact gcaacctctg cctcctgggt tcaagcgatt 13080
cttctgcctc agtctcctga gtagctggga ttacaggcac atgccaccac gcccagctac 13140
tttttgtgtt tttagtagag acggggtttc accatattgg ccaggatggt ctccatctct 13200
tgacctcatg atccaccttc cttggcctcc caaagtgctg agattacagg tgtgagccac 13260
ggcgtccagc tcccacggtc ttcttccttg ccccgacatt tgcctgacaa catggctgcc 13320
cccacatatc cccatgtgtg tagaacttta tggcaccctg catttgcata ttaaaacact 13380
agggtgggag ggccagtttt ttctcaagct acatgaatga catgcttggt aaaaccaatc 13440
ccctaagccc tatgcaaatc agacaccacc tccttcagcc tcctcatata agcagccact 13500
tttccaccgc acatggagtt ttctcttagt tctaatctcc cctctctctg tctctgtacg 13560
gtggagctgt tttcttcttc cttccttctt gcgtattaaa cttttcgctc cttaaaacaa 13620
ccccacgcat gtccgtttct ttttaaacaa acccgcgtga gactaagaac ggtggtggtc 13680
ctccagtcat cagagcccta tcataaggat tctaccttac atagcaaaag aagaacttga 13740
caggtgtaag ttaacgactt tgagaataag caacctggtt atccagatga aaccaatata 13800
atcacaaagg tcattaaaat agaggaggag gcttgcagag aggagctggg acaatatgga 13860
aggatgtggt ttgaggaggg aaggggccat agagccagaa atgtgggagc acctggaaga 13920
taaaagcaga ggattcagtt ctttcctctg gagcctccag aaggaatgca gccctactga 13980
caccttaaca ttagctcagt gagaatgctg acctccagaa ctacagggta atacatttat 14040
gttgtgtgaa gccaataaga ctgtggcgat ttaaacagca gcattggaaa ctaatgcaag 14100
gggaagaaat gtctttcagc tcactgagcg cgtgcttgtc ttctgttctt ggaaatattt 14160
ccaccttgtt ttctggtgtc agttatgaca agagacagag aaaatttttc cgagagaaga 14220
gctaccacga gaattcgttt ttagctagaa aatctcctgg gtaaaatctc atgattatct 14280
gttatacgat ctgggtatca cagagtttgg ggtcagatct cacaacatgt gataggagga 14340
agagggtttt gttagtttgt tttcatattg cgagggaaaa ttagattttc aggacacaat 14400
ctgagaagga cagacagagt cagagatatt gtaagagaaa gaggagatgt ggaaggagtc 14460
agggcaatga aacacgtgtc ccagctccca aatctaaaat aaagtcattg attttacaag 14520
gtgaagaaaa gctcttcacc ttccatcttc ttaggaagga tcaaattctt cccagagtcc 14580
ctgcccctcc ttcacccccc tgacattgca ttgtggagct aatcacatgt gcccttaatc 14640
cctgctcctg tcccaggctg ggagaggctc actgtcctca ccatgcccag caggctagag 14700
ctggtgccct aagcaccaaa ggagaagagg atgatttctg tgcaggcaat aagagcttta 14760
ccgcatttta catttcccta aaattctaag caaagttctg tggagagaag agaacatggg 14820
gcaactttat ctggtggggc tggaagagac caggctctga gaatgacaat taattcacat 14880
ttctactttt ccagatgcca aatgctagct ttatcaattg tggaaatgtg gactttgagt 14940
ttaagaacag gtttcaggta ctgcaataat tgaggagaca tttggaatag agtccttagt 15000
ctagggctaa agtcagactg gcagtgcctg agagcttcca ggcgctggcc ctgggctgtg 15060
agggaagcag cagttctcct gagccacagg gctgaggacc tgggagcaac cacaggcctt 15120
ggccacaggg ctgcctggca ggggcttgag ggaaggaaac tgctcacaaa ttcacaggag 15180
ctgcattaag catatatccc gcagcctggc aagagtgaaa gtctcagaga cccagacctt 15240
agggctgggg ctgggattct gggctggctg ctgtcggctc tgccctccct tgtcctgaat 15300
gactggcacc ctgctggagc caaaaatgga gggtcggcca atgtcctcaa agtctttact 15360
cagccagacc ctgttctgct tggaaagaaa atgaacacat ggtatacaaa taaacataaa 15420
atcatgtgta tctgtaataa gaatttctaa tataaatttt acatattgaa tacatatatt 15480
ttagaaataa gttgtactta tacatttgcc tatactatgt gtctatttat ggataaatat 15540
gtggtacatg tttatatata aagatatata actttggttg ctagtataag gtatagtttt 15600
aaactttaat aaagtaaaca cgaacattga aaatgagcac tgggtgcacc acttcatggc 15660
cctcctcact ccagggccta agggtgataa agctcaggac cctcttccat gtcccccggc 15720
atggacagca gtgaactacc cattgctgag gatcatgagt gacctgaggg ggatctgcag 15780
aatcacagag cagcagatgc ccagaagatt gatagtttgg accctgaatg gagggacatt 15840
ttgatcacag ggctcagcat agacaagtac tcttctggtc atttctgtca aacaaaacag 15900
cacatgtagc tcagaggctg catgatcaca ggatgaagca cctccatgag tcattgccag 15960
cttcccctct gactggggtg atgtgggatc tctctgcccc actttcatgg ctcaccagct 16020
gctgggactc tgttgacagt ggtctacatc tgtcccacgc acaaacttct caatagttgt 16080
cattttactt actggtctcc aataaccaca aattgccagc catgaccctt ccacaaaaat 16140
tgatggagtg gggttggaac tatgggttca gcaatgtgcc agggcatgta tataagagaa 16200
acaaggtgtg gccagcccat gtctgaagtg aggatgaatt ttcaccatga attcggagta 16260
ggaggtggaa gaaaacatcc tgacatgctc caggcagtga tgcccacaag atacactaga 16320
agcgcccaca gaggaggtgg gaagggggtg tgagaaaaag agggagtgtg aatttacagg 16380
tgtctccaga ctgttcacct gaaaagagat cagaccctta acaacacctg ggaccccagg 16440
cagagctgtt gctatggaag atttgtgcag gacagggata ggaggaggga gcacctacct 16500
gtgatggcat cttggttgct gttggccaga atgacatctt ttcaggccta ctgtccctga 16560
cccaggcagg gatcatgtcc aggagggcag caggagctca gagccaggcc ctggttctgc 16620
tagtgccagg ctaggatgtt cttcatactc tggccagctc tacaggtgac agtgaccctc 16680
tcccctgaga cacaaggagg aggacaacga tggcatccac ataacatgct cactgtcatc 16740
caagtggggg aacaaacatg cagatcccca aatattaata ccgagtttgt agttcctcca 16800
acttggtgca attctgatca gaaggaaaaa caggctaaca acttcatcag cagggaaagt 16860
tcatgtttaa tacaaactat ctgaggctga agcctgagtt tcccttcctc accaggcagt 16920
caggacagca ggagcaaaag gagaaaagct gggtcccaaa gtccacaagg tgcctcctga 16980
gactgatcct gcttagagaa ggtggtgaca gtggatgagt cttctgggac tcccacacca 17040
acataccctg agctggatgg cttgagccat agacatttat tgctaattta ttaaacgttt 17100
attgtgaatg tattagaacc ctggaaagtt caagatcaaa gtccagaagg atttgctttc 17160
tggtgagaac cctgcttctt gttttcagat gtcacccctg gatacatcct cacgtgtgtt 17220
cagcaatgtg ccgggcatgt gtaagtagga gaagcaagta catgctttct tcagtgcatg 17280
cttggaggct ggtgaggggt taaggaacag atcgatgatg tttattttta ctaggacaca 17340
aatcctatta aatcagagcc ccaaggtttt cacttcattt caccctaatt accccttcat 17400
aacctctatg tctaaataca gtaattttgc aggttggaga ttcaaaatat gaatttgtga 17460
aacacaattc agttcatagc aggtgtgctt tgaggacatg cccaaggcag taggaagggc 17520
aaggcgaggc ttccagtctc agagcacaga aggcgttttc ccaccactca gcacactggc 17580
agctcctctt aggtgatcca ggtcacacat gagacgccat tcccgccttg ggggctgcct 17640
gctgataatg gaacaatatc acccttaatt ttcactattt ctaagatcag acttctattt 17700
tatgtttatt atggagtttg tccaatggcc aggtttgtaa cataacctcc aatgtttggt 17760
ttgtgacata acatcttata gaattttaga tgctggtttc cagtgagact tgatggagtt 17820
ttttcatggg ttttcatgga gttgatctta ttacatccac cattatgctg cattctgtag 17880
ggaacacaaa atgattcctc tcctcaataa accagtcacc tagttgaaga taaagggtgt 17940
tcagaaaaga tggtcacaaa acaattaggg gctagattct gtgatccatg tgagatgcca 18000
atgatgtgat tctggaaagc agaaggtgag gttgtgagat accctgcagc acataatgcc 18060
caaggctagg gtggcgagta gagggcccct ggtctggatc tgtctaccca gcttcattcc 18120
tcccattcgt gaaacagtgg ctgcaccagc caggaagcat ctgagaccac ctgattctct 18180
ggaataatag ctgctgaggt ttgtgctgtg agctataaca ctgtgagtct ctaactgtaa 18240
ccatttagat tagcactaat gaaaataatt tttaagatgg tgaaaatgtc tatatctatg 18300
ctttgcaagt gtagccgtta tatgtcatat gtgactcctg aacacttgaa atgtagtgaa 18360
aacaactaag gaactatatt gttaatttta attaattcca atatacatgt ttgtggctgg 18420
gtactgctaa tgttggccat gtgagtcagg gaagttttag atggtaataa acagcaatgt 18480
catcaggaca accaatctgc taaatgttaa gcaaagatga tcccaggacc attgcaccaa 18540
gctggagtgg acaaggtgga aagagcacgt aggtggatct ttggaaccca gattctgctt 18600
cctccaggtg aatgatgtaa actctctgtc ttgaagacac tgacattgaa gctagcgact 18660
ggggagctga gtgtttctcc tggaagctgc agtggaaaca gaacatagat cttccttagt 18720
attactcatg tccctctcca taggcttccc agcagagagg tgctgtctga tcaagtggga 18780
ggtgaatgct gtgctcccta atcaatagtc tttctcagtc ccatgggaca tatgaaccct 18840
gtcacatgca gcccacgcag ttgaagccag agccccatgt ccagtgtcca gtgttgcctc 18900
tgccttcggt gatcccaccc tacaggaccc agtgatgaag gcttgagtgg cagggaagag 18960
ctttggggag cctgccaact agcaataagg gtgcagactt gggcttccag cttctgagca 19020
agggaacatt gtatgtccta ggtgtgatcc aggtcaaggt gtttgataaa agatattaca 19080
ataaattatt ttcttaagaa aataaaaaca cagaaggcat ctgattatta taggactgtt 19140
tgggttttat accactaaag tggtaaaaat aaatttttca atgcgcagtg gtttatcagg 19200
aatctcccag cccctgccct tcccgtgatg attctgtagt ctttgcaggt tgtatggtca 19260
cttggtggcc tccttaccga tcagatgcat ctacagcaca accctaagat cttccccgat 19320
taacatagat gagcaacttc aacctccaga taccacatac cattggctga tttttatgca 19380
atttatcaac actgaaagta ttctattcca tttcattatg tagttattat tctgtgcatg 19440
gctcattccc ctactgagta tcagtatttg cgatcaaaaa ttgttttatt tacttacatg 19500
cactaaacct taaatgatag catttattag ttctgaaaac tctgacatta agttaaaatc 19560
ccttaaaagc aactatatgc ttcttttttt aattagaata aatatggtgc aatcacctca 19620
actaaggata ctaaactact tttacagttg aaaatgatta attggacatg gggaaacata 19680
ttgacaaaag taacaagcat tattatgatg ttgaataaac acagtttgca tgtaaagtgt 19740
acagttatga ttaattgtat taaaacacag gaggaagaaa ggtggggatt gctggattgg 19800
ttggtgattc agtccttaga agcaaggggg agctgatgag tgatctcagg caggcatcca 19860
atataaggtc caaatatgat taattacaat gttcttttcc ttaaggtttg atattttaag 19920
ctggtcctgc tggggaagtt ttgagcacat tcatggaata tgtggaataa agattaaaaa 19980
cagtatattt caaaatactc ttaaaaagct cagaaacacc caaagaaaac tattttataa 20040
aatatcatgc cttcctcgcc cattcttgat atttgtgttt aaccaagcat gactcacaat 20100
tcaacttttc tccacattgt tgcctagagt gttgaagaaa ttcctctaat aggacagaaa 20160
tggagtcaat cttgcaatat ctggccaatc gtgttctggc cagtcttgct ttatctcaga 20220
atgttacatt tccagaaact tctacagtta ttcctgaaaa ctacaagcaa gaaagggaag 20280
gagactggga tcattcaagg caaaatggaa cctgttctgc aaatactgta gtgaaatcat 20340
aactcagtaa tcgttttgtg actggcttat ttcacttagt gtaatgtcct ctagtttcat 20400
ccaagttgta gcatgtgtca gaatttccct ttttaaagct aattttgcct ttttaaagct 20460
acaatatgct actgtatgta tataccacat ttggattacc agttccctcc tttgtgaaca 20520
tttgagttgc ttctaccttt tggctattgt gaataattcg gttctgaatg tggatataca 20580
aatatatcct caagttaatg tcttcagtta cttgggtata tgtccaaaag tggaattgct 20640
gaattatata gtatttctat ttttaattct tcgaggaatt gccatctggt ttcccacagc 20700
aggtgggcca tttacatcac cacgacagtg tccacaggag ttccagttcc ctaagttctc 20760
accaagactg gtcattttct gttggaaaaa aaatcctaat aggtgtgagg tgggttttgt 20820
ttttattttt ctaaggatta ataatgttga ccatgttttc ctatgctagt tttctaatta 20880
tctctataga atcttcttta gagaaatgtc gattcatgta ctttcctcat ttttaatcag 20940
gtattttatt ttaaggttca catataagac ttatttttgt atagtagata ttattaaccc 21000
cttatcaaat ataagattta caaatgtttt cttctattcc acatgttgca ttttcactgt 21060
gttgattatg tcttttgatg cccattttac atttttatga agtccaattt atcttctttt 21120
ctacttttgc ctgtattttg gtattaaagt tgttagtatt taaatgtcta taaatactga 21180
cttactatgc tgagaaggtc acactgcacc atctctctga tggtggagct aagagtttta 21240
cactctccca ttttgtaccg ggggacagtg cagctatgtg agaacccagt ggctttaccc 21300
agcttatttg tcttgcattt ttggtgacat ggattgttat tcacattggc ttcctctggc 21360
aggtccacct ggaaagcatt atatttagca agaaaaaagg aggcagtgaa tgatgtcact 21420
gtggactgtg tatattccct gttgcaaatg tcaaattcgt gaagcataaa gggatttact 21480
agaggatatt aaattccttg caaattgttg aaaagcctta aggaacaggc tccaggcaaa 21540
gcctctagaa caattccaag aatggcactg ctggcacagg ctggggagga gctcctcctg 21600
cctgagactc cacaacattc aagctgtctc ctgcagaaaa gagagcagct cttctcacta 21660
ctgcccccag aaggacagcc gctctgctat caactacgag agatctgacc cctttctctg 21720
actgcccatc agatgtgtta ctacagagtg cttttggatt gagatgaggg agggaaaatg 21780
cctgatctca ctcaaatgtg ctcattttcc tggtctgggt ctcagccagg cagcacagtc 21840
ctgtgggcac agtatcttca cttgccaggt tcctataaaa tgagagtatc tttcttgact 21900
gtggaaaata tggggatggt aagggtcaag gaataggaaa aggagtactt ggagttgcct 21960
gagctgccac tctggtttcc ccaaatgttt tcaatccatt aaattcatga taataaacac 22020
ctttctgcct aaccagccat aatcgctttt cttagatcca aatgattctg tgataaaact 22080
aaagagaaaa aataaataca cttttcaacg tttaagctga ccaggaggct gtctctggtg 22140
tttacatgtc catatcccac tatgcatttc gtcttccctt tgcctcactg gagatccaag 22200
tgcagggaat gcttcatatg actgtgatcc ctagaacttc atcctcatga ctgttgaaat 22260
cttctctgag ttttaccagt ggaaatggca ataaatagaa agattccaga aggtccccta 22320
gggtccatat tttctgtact tcctctctaa aatatgtaaa atcaattata tttgctcttg 22380
ctttatatgg gctacatctg tgtccccagc acacacccta acgccctgcg ttgacaactt 22440
atccagtatt gtattaagtc taaataggca catgtttatc atattatttc ttccaattta 22500
atgagataat tgtcatgtca aatctttgga ttaagaacca tcagccagaa aaccacagcc 22560
ctgagaaaat agaaatagag tatttcaagc tgttcagttt gcacaacaat gatgattcta 22620
tagctcattt acaagatata aatattctgt ttatgggagt aagagcaaca ttcacggtga 22680
gtgttgtaga ccctccgcca catctgacag catagcaatt caatagcaca agggtttgtg 22740
tgccagcagt gcttgactaa taatgggttt tttttctata gggaaagctg cacctgtgca 22800
catgacagga tcatgagcta cactttactt cacttttttt gaagtcaatt accttcttga 22860
tccaaagcca cagtatggaa gaacttcctg actctgatga aggcatttgg aaaatcctca 22920
aataatattt tatgcagtaa cataaccaaa gacaaaggaa aattcatata taggataata 22980
accactgctc tcctcatgtt acatgaagtg cacttgaatc acctgacatc agctgttagt 23040
atgagccctg atgtgtggta gaatgttagg ggctcaggaa gggtcaattt tcttggcaaa 23100
ttagtgttca agagagccag tagccctgta catctcagtt agttgaaact catattattg 23160
agtccccaca gggacctccg taacagtggt tcatgaggtt acctgggaaa gtgggcaaag 23220
gtgactgact gaagtccatg tgttcaatca tcctcattat gaaaagcccc ctgctcatta 23280
atggcatttg gattaatatt cactgagaaa gcatgttttt cgattatggc tcatttttga 23340
aacatctagt catagctctt ccaaaatgac tttgtctgca atcatcctgt tgtgtttctt 23400
ttaaggcctg atgatctgtc aaaaccaaca accaatatta ttaaattgct gttctctttg 23460
caatgtggca atgtgatcat cagatgtagg ccttgcagtt tacccacggt taggattttt 23520
acatttccag ggattccttg acaatggcac taatgtgacg ccatctagca tccattgttg 23580
tgagaactct atttggaata tcatcattgt gggcatgaac ataatggaga ctttcatagg 23640
atgcaatgat taatattcaa cattagtcaa aatctgctgt agtcctaccc ttggagatct 23700
actggtttgg aaaaatattt taggtaagga caacaatttg gtaaagtttt aaaaataaag 23760
gctaaaaaga aattttcttt agcaagagta tgaactatct gtggtccaga ataccatttt 23820
tttacagatg caagaaaaaa ttatttaaat gtatataatt tagataataa ttttgtaaat 23880
ttgtatatat tgcatatata atagaataaa cataattaaa tatgaatact atatatactt 23940
atagccaaca ttttatcaaa taaatatata ttaacttcta tgtatcttat atatatgcac 24000
atttttccat aaataaggta aattttaatt ttttaatgaa atactaatta gttttaattt 24060
catctttaat tttctcttaa taacttcata atttgattac ttaatgttca catttatacc 24120
accaatttaa gaaaaaacac atgtatctat atataggcag aggtgtaaat actgtatcag 24180
taagctttta tgcattaatg attgataatc ggttaaatat acaactcagt ggctgataac 24240
tgtaaatatt tgttttcatc ttcatggatg ctcatgttca caatcatctg gctgattaag 24300
gaagggctca gctgattgat tcctccgcag ggcactgagc ttgtctttag cctacagata 24360
ccaattttct gaggacgagg ctgaacagca gtgactacac gtgacacaag attcttgtga 24420
caggtcacag gagtgaacaa catcccaaac cgaactgcac agttgaattt aagtccaata 24480
atttctaaca tagcttcaca cattttaaat atattttttg atttcagtga gtacaaattt 24540
tcaagaaaat gtttactcca attaattata gaggtgtttg atcattccat ggacaagtaa 24600
ttatgttttc aacctttaca atcctgaaaa tatttgcaaa cgtaaatttg cattaataag 24660
aaaataaagc tggatgtgtt ttcaacatgt gcttttaaat ataatttttg aaatgacctc 24720
aaagggggaa aatcatttta acttatgtaa ctatcccttt ttacctctct tgtgtcctat 24780
agagttgccc aataagaggt cctcccatga gatttggaat cagaaaagga tgactcaata 24840
ttctccattg gtacctaagg cagacacagg aacagaggtg aggactagag aaacacctga 24900
aaagatgctg taggaagctg agagcatcag cacccccacc cctaagcttc cagacaggac 24960
tgaggaccac atggttagaa agcccttact tcagggacag atgcattctg ttttctgagg 25020
gagcaccaga gattcctgct tctaatatca gctttcctga ctactatatc cttggctttg 25080
aaaggtcata gtgggaaagt taatcatagg aattcggtca ttcttgtgat acccgacaga 25140
gccaagaaac caggagggaa aggcactcag ggtgaaaaat actgtttcta gaatgcaatt 25200
gaaataggcc ctattatccc atggaactaa agtttatggt tttttgaata aacagaaatc 25260
gactcctcca gtcttaaaac tcaagatagc aacatttatc ttacctttct tttttttttt 25320
tttttttttt taaatttcag gaaagcaacc atcaggcctc ccagatacta tcaatttgct 25380
gaaacttata tatcactgaa tcgggacagt gagacatcag acccttcacc cattatgatt 25440
gcctaactga cctcctgctt cctgttgacc caattatctt tcttaaccct ccctaactcc 25500
tgtttttcca catttcttcc ttgttatata aacccctaat ttcagttggt cagagagata 25560
catttgagaa tggcatccca tctcctcagc tgcagcacct gattaaagcc tgttccttga 25620
aaatacttgt cttagtgatt ggctttctgt gtgacgagct gcaggatcta caccgaatcc 25680
ctggcatttc agtaacaaaa ttctctgcaa gcttcaccgt tttggtttat tgtaacctga 25740
aatcaaattt atccaaaact tctgagataa cttgatataa ttctaggatt cactttgtcc 25800
accactgctt accagtctga gcttgccagc tcccaaccct tcctagtgcc aatgagcttt 25860
ctcaaaagag ccataggtaa cattttccct ttttcataaa atgctaaatt tctctttgtt 25920
cttccaacat attgaagacc actgagtttt cctgtatgcc ccatttggca aatatttctt 25980
tgcaaataaa acattaaatt tagagattca tctctacatt ttatttagac ttcagtagtt 26040
tactctaatt ctctgtatta agactatatc tgcttcaaat atctatagtg gcttcttctc 26100
tgttatacga attccaactg aagccataaa ctagactctt caggtgtcat gatctctgtc 26160
tttattaaat caagagaggc attgctagaa ctgtgcagtt ggggctgaga aagagaaaag 26220
aattagggtg cagaggtgac ttcgtgtccc cctctaccaa caccatcaga gtgtggctgc 26280
atctgaggaa caatctcagc caatggaggc atcaggagga gcagctgggg cagcccagtc 26340
tcacacatct gcttccctgg gggtttctgt tcgggtgtgt aacactgtgg gagggtaatt 26400
gtaatcttgt agacagtaat aagttgcaaa atcttcaggc tgcaggctgc tgatggtgag 26460
agtgaaatct gtgccagatc cactgccgct gaaccttgat gggaccccac tttgtaaact 26520
ggatgcagca tagatcagga gcttaggggc tttccctggt ttctgctgat accagcctaa 26580
atcatttcta atgccctgac ttgcccggca agtgatggtg actctgtctc caacagatgc 26640
agacagggag gatggagact gggtcatctg gatggcacat ctggcacctg agattggaaa 26700
cacaaaaaca aatggtccac acaattaatc atgtagtaag agaatttccc tgaatagcca 26760
ggctgtgctg agcaccctgg gctgagtaaa ctgccagtgt tctccatcct tacctgggag 26820
ccagagcagc aggagcccca ggagctgagc ggggaccctc atgtccatgc tgtgtcctga 26880
gtgggtctga ctcctgcaca gggtgtgatc agcctgttaa taagtcttca ggtcaggaga 26940
ctgtgctctg ggaacatgca aatgagcagg ggaaggggca ggctgggcac agctgcaggg 27000
ctggctcatc tcagtaactc agcaccggct cagtgtcccc aggtgtccca ggtaagacca 27060
gggtagcaca aatttgtctg cagagaatgt gtttctactg gggactattt tgttatgaga 27120
aacattttaa agatattttt tgacaatatt cctcgagagt caatggggta atatatttca 27180
ttggtgtatg gggattattt tggagaatat tcttgtttgt aggaaacaca gtacatatta 27240
gatggtacga ttctcaggtc ttcaaaagac tgttataaga ttccatttag ggaagggggt 27300
aattgtgcta tacttgaaac atttctgtga gtttaacatt gttcctttct aaaaaattaa 27360
aaataaaatt tattgacatg atgctatata tatttgtaag tattaggtaa tggtgttatg 27420
ccattgttct taccagtata agatcaaaca atttactaca gatacacaaa gatgatgccg 27480
tgcttcttca atgcatgtgg cactaacagc cccaccatta tcaagagcta caggtctttt 27540
taatacccag agactaaatg ggctgcacct gtgtagaatt tttgcatccc taacttaagt 27600
actaatagat tgcttttgat tggaagcctt agcaataaaa taaatagttg attaacatgt 27660
tttttaatgt tatatatatt atatactcta ttattccaat aaagtatgct aaagaaaaaa 27720
atgttattaa ggaaaccata aaatagagaa aatatattta ctacttatta agcatttgct 27780
tacaggtgac acacacagaa caaaatataa gtgtatctgc aaatttcaaa cccaagttat 27840
tcaagggtta actgtaccat gatgaacgta gcagtcccca tctgtaatct agggctttcc 27900
cctttgctgt acctctactc atttccaatg accatatata tgtcttatgt tctttatgat 27960
cttgggcaga gaactctgcc tggatgcatt gctggccaga tggcctggaa tgtgtatctc 28020
ttaggaaagt gctatggttt gactgtgtcc tccagaatcc atctattgta aagttaattc 28080
tcagtgtaat ggtttttgcc aggtggggcc tattgggatg tgtttaggtc atgaggctgg 28140
agccctctag cggaatacat taatgccact ataaacagga attacagggc tgagatctct 28200
ctcctgctcc tctgacatgt taagacatgg ccttccttcc tttgaagaac tcaacgctcc 28260
aggcatcatc ttgaaagcgg agaaagcaga ccatgtggtt gatcttcagt tatcctgagt 28320
caggtaggtt gttgatgtgt cttttaccat tcattttctg ttccctccct cactttcctc 28380
ctttcctccc agtataaatt tgctacctaa caggaatcct tattgctggt ggatccaaac 28440
tgagagagta aaaaagaaaa gtcattaatc ttttgtatga ggggtatttc tcatctgaaa 28500
tcttaccatt tctctttctt tgatatgtac aaatattcag gaagcaccta attttttttt 28560
ttttaccaat gtatcttaga ttgaatttac gctgtgattt tttttctgtg tgttaaaaca 28620
aaaaatcaag ttgtaagcca ccaacctact caatgggctt ctcttttggc agagagaacg 28680
tcaaagaaat ctgaaaaact aggttaggcc atgactggca ggtgggttta gatgtaactc 28740
attatactct cctccctttg gagttcagac aaaactgacc agtgttatca ttacaacaga 28800
gatctttaga ctgacaaatc aaatgctttg tagcaataag ataccatact ccaacatgac 28860
agataatagg ccctgaagaa aatctaaata ttgtacccta aaaatatttt ttttgatgta 28920
ttctgaagtg gccctgcaaa gctgcctgtt atgggggaaa tttgcattct gcagagcatc 28980
tcctcctctt actatgtctt ttccaaagag ttggacattt ctttaaaggt ctgataagca 29040
acattcacca tctactttac tgttacctgc aaggttcatc taagtgacaa gaaccttgac 29100
ttccacaccc ccttatctaa actcaaggat ttctttatga tgaattcaac tctttaggca 29160
gagcttaact ctttcaacca gttgccaatc aggaaaactt tgaagccacc tgtgacctgg 29220
aagcccctgc ttcaagatat cccacctttc caggacaaac taatgtatat cttatatgta 29280
ctgacttagg tctttccctg taatttttgt gtctccctaa aatgtataaa accaacgtgt 29340
aatccagcca ccttgggcac atatttgcag ggcctcctaa agctgtgtca caggccataa 29400
gccttatctt tggcaaaata aacctataca ttgattgaga cctgtctcag atactgtttt 29460
gtttacactg ggtcacaaaa gttaaaaatc ctctaaaact ctctacacat ctataaatct 29520
acattagaga cagtggagtg agtatacctc aactcaagtc atactttgag tttaagaacc 29580
agacagattt tcaggtactt cgataaatga ggagacattt ggaatagggt ccttagccca 29640
gagctaaggt caggctggca gtgcctgagc gcttccaggc cctggccctg gtctgtggag 29700
gaagccactg ttctcctgag ccacagggct gagaacctgg gatgagccac aggccttggc 29760
cgcagggctg cctggcaggg tcttcaggga gggaaactgc tcacaaattc gcgggagctg 29820
cattaagcat atatcccccc agcctggcaa gagtgaaagt ctcaggacac agaccttagg 29880
gctggggctg ggatcctggg ctggctgctg tcagctgtgt cctcccttgt cctgaatgac 29940
tgggaccctg ctggagccaa agagggaggg tcagcaaatg tcctcaaggt cttcactcag 30000
ccagactctg ttctgcttgg aaagaaaagg aacacatgct acaaaaataa acataaaatt 30060
atgtgtattt gtaatatgaa tttctagtat aaactttaca tattaaatac atacatttta 30120
gaaataagtt atatttatat atttgtatat actatgtatc tgtggataaa tatgtgatgc 30180
atgtttatgt ataaagagat gcaagtttca ttgctagtat aaggtatagt tttaaacttt 30240
aataaattga acgtgaacat tgaaaacaag cactgggtgc accacctcat ggcccctcct 30300
cactccaggg cctgagggtc ataaagctcg ggactctctt ccatgtgccc cctgggccga 30360
tagcagtgag ctacccattg ctgaggatca tgagtgacct gagggggatc tgcagaatca 30420
cagggcagca gatgcccagg agatggatag tgaatttgga ccctgaatgg agggacgttt 30480
tgtccacagg gctcagcaca gacaagtcct tttctggtca tttctgtcaa gcaaagcagc 30540
acacatggct cagaggctgc atggtcagag gaataagccc ctccatggct cattcccagc 30600
ttcccctctg actggggtga tgtgggatct ctctgcccag ctttcatgac tgaccagctg 30660
ctgggaccct gttaacaatg gcctatgtca gtgccatgca caagcttctt gatagttacc 30720
attttacttt ctggtctcca ataaccacaa attgccaacc atgaccgttt cacaaagatt 30780
catggagagg ggtcagaatt atgggttgag caacgtgccg gggcatgtat gtaagagaaa 30840
caaggtgtgg ccagcccatg tggaagtgag gatgaatttt catcatgaat tcagagaagg 30900
aggtgggaga aagcatctga catgcttcag gcagtgatgg ccacaagata cattagagat 30960
gttcatagaa gaggtggcaa gtgggtttga gatgaaaagg gaatgtgaat tcagaggtgt 31020
cccccagcct gttcccctga gaagatttca gacccttagc aacccctggg cccccaggta 31080
gagctgttgc tagggaagat ttgtacatga taggggacag gaagagggat cacctacctc 31140
tgaaggcatc ttggttggta gtggccagag tgacatctgt tcaggcccat tattatccct 31200
gacccaggca gggatcatgt ccaggagggc agtaggagcc agcaggagct cagagccatg 31260
ccccagttct gctggtgcca ggctaggatg ttcttcatac tctggccagc cctgcaggtg 31320
acagtgaccc tctaacctga gagacaagga agaggatgaa gatggcatcc acataacatg 31380
ctcactgtca tccaagtggg ggaacaagca tgcagattcc caaatattaa taccaagctt 31440
ttatttcatc caacttgatg aaattctgat cagaaggaga aacagtctaa caaattcatc 31500
atcaaggaaa gttcatgttt aatacaaact atctgaggct gaaacctgac ttccccttcc 31560
tcaccaggca gtcaggacag caggagcaaa aggagaaaag ctgggtccca aagtccacaa 31620
ggtgactcct ggggctgatc ctgctcagag aacgtggcaa cagtggataa gtctgccgag 31680
aatgccacac catcatactc tgagctggag ggcttcaacc acagacattt attgctaatt 31740
tattagacat ttattgcgaa tatattagaa ccatggaagg ttcaagatca aagtccagaa 31800
ggatttgctt tctggtgaga accctgtttg tttccagatg tcctctctgg atacatcctc 31860
atgtgtgttc agcaatgtgc caggcatgtg taagagaagc aagtgcatgc tttactcagt 31920
acacgcttgg aggctggtga ggggttcagt aacagctcaa tgatatttct ttttattagg 31980
acacaaatcc tattaaatca gaaccccgat gttttcacct catttcaccc taattacctc 32040
ttcataacct ctatgtctaa atgcagtaat attggaggtt ggagattcaa aatatgaatt 32100
tgtgaaacac cattcagttc atagcaggtg cactttgagg atatggccaa ggcagtagga 32160
agggcaaggc aaggcttcca gtctcagagc acagagggca ttttcccacc actcagcaca 32220
ctggcagctc 32230
<210> 81
<211> 116
<212> PRT
<213> Intelligent people
<400> 81
Met Asp Met Arg Val Pro Ala Gln Leu Leu Gly Leu Leu Leu Leu Trp
1 5 10 15
Phe Pro Gly Ser Arg Cys Asp Ile Gln Met Thr Gln Ser Pro Ser Ser
20 25 30
Val Ser Ala Ser Val Gly Asp Arg Val Thr Ile Thr Cys Arg Ala Ser
35 40 45
Gln Gly Ile Ser Ser Trp Leu Ala Trp Tyr Gln Gln Lys Pro Gly Lys
50 55 60
Ala Pro Lys Leu Leu Ile Tyr Ala Ala Ser Ser Leu Gln Ser Gly Val
65 70 75 80
Pro Ser Arg Phe Ser Gly Ser Gly Ser Gly Thr Asp Phe Thr Leu Thr
85 90 95
Ile Ser Ser Leu Gln Pro Glu Asp Phe Ala Thr Tyr Tyr Cys Gln Gln
100 105 110
Ala Asn Ser Phe
115
<210> 82
<211> 32230
<212> DNA
<213> Intelligent people
<400> 82
gaattcacca ttttaaagtg tacaattgag tggcatttag tacattcacg atgttgtgca 60
atcatcactc ctattattac tctgtaaact ttacaaattc atcgtattta tttatttaat 120
ggttgttaca gtttgcaact aaaatagaag gaaatacatc aaaatattag cagtggctct 180
tctgggtgaa gtacaagggg caaattgttt tctcctgttt gtttttctgt acacgttgtt 240
tactgtgtca cattgtttac tgtgaatagt tactatttga aactaaagat caagggcgat 300
aaactgtatt ttaagaggaa gtcagaaaac aaacaaggtg gccctctcgt atgctgtgct 360
gacacctgtg tccctgtagc ctcaactacg cctgttgccc ccacctgcgc ctgaagtttg 420
aggtcgctgg tggcacctct gtgccagggg gccctggaac ctctcctagg atggtcccag 480
agaaaggaga gagatctgct tcctggaatc tcagctctag atgctttggt caactccatg 540
tcatctgtgt ttgataagct tgatttccat ttgttttggc ccctctttta gtgtgctttt 600
tgttagcaga aactcacgaa ctagagaact gcaggtcccc caggggagtg ggttgagatg 660
tttttgacat cagccacctc tttctcccac agttttgtta ttaaaacccc attttaacaa 720
ccttgaaaga caggttttaa aagaaagttg caattttctt acaattctac tgcttaatta 780
aaagagtagg ccctgtggtt ccctttcccc atcctggtgg tgttctccct gcccctgtgg 840
tggtgttctc cctgcccctg cctctcacca gtgtatgctg ttcccaggtg gcagtaatcc 900
tatctcaggt ctggcattcc aaggcaggct cctgctcctg ggtggggagg ggcctccatg 960
ctgggttgaa tgtctgtgct ttgctgtccc ctgacccaca gagtgccctt ggacaggaca 1020
taggtctcag tttcctaagt gagagtcccg gattagatgg actgtggtta accctttatg 1080
tgtcatggcc tctttctgta taaagccaca gatctttccc tgcaatgagc atttatacag 1140
acacttttca gggttttgtg aacccgtgag ctggacatcc tagagctctc cttcaatccc 1200
atggcctcta gggtaccctg ctctggaaag gcaagactgg gcctcttttt tgggaccccg 1260
gagggcagac cttgggtttc gtcgtggcac ccctgctggg tgatgtgccc agggctttcc 1320
acgatgatcc cactgaatcc tcacatagcc ctgaggggaa gctgccacca tcatcacctc 1380
cacatcacag aggagtacac aggcaggaca gtcacactcg gacaagtggt ggagccagga 1440
cacaaaccca ggtctgtctg gactctaagc ttaggctctt accatgaact gtgatccaac 1500
catcgggaga gtcagcccaa tgaccttcaa gttccctcca atgctaaggt cacacctgag 1560
aagcttgcta gggtttctaa agcatcttcg tgcacatatg tccttccagg gttcttccca 1620
gcagtttgtg agatgggcag ggcagatgaa gggaaaaggc ttcaagacat taaggaaagg 1680
gcccaagatc acacccgagt caggatcaga gcaggaattg gaatctaatc tctacacaga 1740
gttgccagat accaatctgt gcttctcatg gttagaattt acctacttat ccaactattc 1800
acccatccaa ctacccaccc acacatgtac ccaccagtcc acgcattcat ctatccagcc 1860
atccactcac ccacccaact atccactcat ccattcacct accaatccac ccactcatcc 1920
acccatcaat cactcaccca tctatacatc catccaccta cccctttctc cctccctcct 1980
tctttccctc cctccctttc tttcctcatt cagactgttt attgagagcc ttgaaggtca 2040
ggcacttgga tggctgctgg ggagatgaag cttgaagatg tgtgaacggg ctgctcctct 2100
tggagacatc atcttttccc tcatcagtga gggttctgga aggggaatgt gggttgggag 2160
gcaggcagga tggagaggtg gctgttgagt tcctgccctt tgggttttgg gtcacagtac 2220
tagactcata gaattgggtt aaaaacttgt attttttttt ctaaggagaa gctggaaagt 2280
gaacaagtaa gatagggcgt ctggctcctt gctgtgtata gaacagatac ccagcaatga 2340
ccataggtgc agagtttatt tatgtagaga ctttttgaat ataagaaaag aaatgacaaa 2400
tatatatgag ttactatata atgaatataa gtataattaa aataaaccaa ctataggtag 2460
tgcagggtga gtttccaata ataaattcta aaccaacttc catcattcat ggaaccagat 2520
attctattca ggaattaata tgcattctcc catacatttc ctattataca catgggaggt 2580
agctactcat attaaatcaa tatcaaatag atgggaacat gaggagagag attagctacc 2640
aaggtaaatt gtcatctctc agtggcagag aaatttgtca accgaggtct tcctagaaat 2700
atgctctgac ctaccataca attcttcctg cctgaggaac tggtaaaaac tctccaagtc 2760
catcctggct tccttctttc cttcccaact tctgctcatc ctgacctgac cttgtcccaa 2820
gctgctctat ggcttttatt gctctttgca gaaatcgctt aaactttttg tttgcagttg 2880
ctccctcctc tgtgtttaac tgtattttaa gggggggttc attttccaat cctctttgct 2940
aaatgtcggc tgctaggtac tcatcccccc tggaatgccc tctctttcca tttttatgac 3000
tcagcaactt tccctgggct tcctgcctct gagctggctg gagctgtgag acaatttcgg 3060
gctttgggca gcacctaaga catacaggat gcgaatccat gttaggatcg tagtgacctc 3120
ttccatataa tcccccattg tactactcct caagagagaa cactctgtct tctcatcagt 3180
gtaatctcaa accctgcacc ctgactgttg tgggtgtagc agacacacaa gaaatatttg 3240
ctgaatgtta agtgaattgg aataaacatg ttgatttaag tgacaaaacc ttctattttt 3300
cataataata aatgtataat gattgtcaaa aaatgaaaaa agttagatgt acaaaatgaa 3360
aaccaatatt acctacagtt tacccccgca accggtagcc ccggggaata gatgtggata 3420
cggatgtgca tctaggtatg gataaaaatg cagggattca tgcacacaca ggtcacgtct 3480
tatctggtgg cctctttggg ataatatgtt caaggctttt cagatgccat tcgcatcatc 3540
gaatacagca tttttatagg atcttacatc ttaaattggc ttaatgtttt gttctccgat 3600
tataaaatct gaaaacagga aaaattaaat aagaatacaa agcaagtctc tgatcctgca 3660
ctgcccaaga ggccctgtta gcgcgttggt atggcgcctt ccagatcttt ttctgcatga 3720
aatcatgggc ttatcacaaa gatgggaact tctttcctca cttcttcttg ccctgttgtg 3780
aacatctgtc tatggccctt ctccaaggcc atctggggat gtggatgtga ggctggcatc 3840
tgctctcggg ctcttttctg tcacgttttg ctgttagctc cctggctaac atccacatgc 3900
actggctctc tggcatctcc atgataaatt cttatgagca ggatttctgg gtcaaaagag 3960
agtgcattcc caggctgtgg agacagggga cacgttcagg agggcctaaa aggctgaacc 4020
gtgtctcagc cttgaggcct ctcagaatcg ccagcttggg aagttaggag gcctgtggtt 4080
gctcatcact ccctcaccaa ctcgttctgc ccagggaagg tcctggggtg ggggcttcag 4140
agccctgtcc tggccacccc cctccctggg gtcctgctga caatcagggc cactgctggc 4200
tggttctgag atgccttctg gtggaccctg ggacccagga tggagctcag ggtgtgggga 4260
ggcagccagg gggcagcatc aggcccaggg gctggactag gagggggtgg ggtggggcgc 4320
aggctctact gcccccacct gtgagctgca caaacatcca gcagcagccc tgaaactgcc 4380
ccatgctcct cctgggccac acctgggcct gtttgtcact catcccatgc ccgggtggcc 4440
atgagctcag tttctcttcc tcttattttt ctccttttgt cactctgagt tctggtttca 4500
gccaacttgg ggttaaattt agcctgggga tttccagggg tggccagctg caggcagggc 4560
caccagagct gggaaagcgc atcccccaac cccatccctt ggcctggccc ccaccctact 4620
cccatctcag gcctccctgg ccaacccctt cacccaggaa tctgctggtt tcctgaatgg 4680
ctggcactcg gggtccctga cccagttcct ccttgaccag agggaaggct gggcccagga 4740
aggcaaaggc atttgcccag gttcacacag tgtcacccgc aggcccaggc aagagcaatg 4800
actgagggta ggtgagggtc cccataggcc aggcacagct taggcatcat ctcaatccgc 4860
aaacctacct tgtggggagg gactcttatc acccccttgg gcagatgagg aaactgaggg 4920
ctacagaaga gaagcagatt gctcaaggtc aagggttgat gagggctgag catggtgggg 4980
ggaccccttc tctgtctgac actgaggtct gggctcccag ggcagatgcc cctttgggaa 5040
gaacagtgct ctgggctccc acaggccttt gcagccaccc tccttccttg catctcccaa 5100
ggcacaggga aggaatggcc atcagggcct gtagccctaa ctctcatcca tgctgctttc 5160
aggcctcttt tctgcacccc tgaaatgggg ctggagctgt ggaatggtgg aggaagtgaa 5220
caatctggtc tctggcagag ggcagtggtc cacacagcca ccctccatac aggtcttctc 5280
catgcaggct cctccacacg ggtcccacca cacagcgccc tccacacggg cccctccaca 5340
caggtcccct ccacacaggc cccctccaca caggcaccct ccaacagatc ccctccacat 5400
gggcccctct acctggcacc ctaccgacag gcccctccat gcgggcccct tcacacatga 5460
tccctccacg cgggcccctc cacgcaggcc cctccacatg ggcccctcca cacatgattt 5520
ctccacacag gcccctccac atgggcccct ccacacatga tccctccaca cgggcccctc 5580
cacacatgat ccctccacac gggcccctcc acacatgggc ccctccacac gtgggcccct 5640
ccacatgcca ccctccatac aggtcccctc cacatgggcc cctctacatg ggcccctcca 5700
cacaggggcg cctatgtgag ctcgggcaga tccctttctc tcctggtctg tttctccatt 5760
tgtcagatgg gaggccctgg gctggaagtc aggacaccac agagctggct ctggcttttt 5820
gggatctaac tgctctgggc ctcagttttc ctacctgtga aatgggacca tgattctggc 5880
tgtggcctca cagaatccct gagtggctca ggtggataac atgtgtccac gtgttttata 5940
aatggtacgg gacgataagg ccactcaata gcgtctcaac acaggatgca gctacctgta 6000
gagttgcaga tgtggtcaga cctgaggttt agggcctcta ctctcggcct tgctctctct 6060
gggccctgcc cctgcccctc tgcagagctc tggggcttgg ggcactctgg tccactggcc 6120
tggaccagca tgaatgttca tggccttggt ccaccgtcca acccagagaa ctgtgcaccc 6180
tgcagggccc tgccttgggc ctggctccca gcatcctctg ctcattccct ctcctccacc 6240
gggtggtcac tacctgtgtc ctatgcaggg cccagacctc ttttctccct tgttccctgc 6300
ccccctggaa gcctggtcca tcttggagcc catccatgtg gcacagactc caaggacttc 6360
ctgggtatta agtagggtgg caggccaggt gacgtggggg acagagtatg gggcctttga 6420
ggtgagcttt cagggtgctt ccatgagggc ccttgtgcac tactgtggcc ctgtgggaag 6480
aagggatgct gtggtcactc ctataccttt gctcacactc acccctaaca cacccgtcct 6540
ctctctgccc ttcagtcctt gatccagctc ctaggcctgt ttgaggttgc tgctgccacc 6600
aggctacctt tgatgaccac atggaatccc cagtatctcc tgccccttgt cttcttcaag 6660
caagggggtc tcatctgcaa tctgagctct gggctgggcg gggacaagta cccccccttg 6720
cttgctttac ttcaggaact ggcctgggtg gctggcatcc tgtgcatgtt gaggggacgg 6780
tggtggggga tgccagtgga tgagctgatt gaagatggtg ctgggtctag ggccaccctg 6840
ttcagcctcg tgggtgggcc tgtggggagg aaggcagagg tgggggcact catccctggc 6900
ctgcccaccc tacagttcgc atcttatgtg tcaggtgaca tgtgcaatgg ctacgtgtgg 6960
cgggcctggc tcctggcttt cctgggccaa gggagctcca ggctggtgtc ctctaagaat 7020
gagctggtga agtcccacag gtggatggga tttgccgtct gcaggggtga acccaggccc 7080
tgaggctggg tacttggtct cctcccatac tctcatcaga acctggagcc ctggaatatc 7140
ctgggaacgt ttcctccaca tggagaaaga cagggaggtc tgtaacgggg gcagtgggta 7200
ggatctggtc atcggacagg gggcattaag cctcaccaca gtggcctgtt cctcacacct 7260
gtcaacctct ctttgacctc agcatctaga cccagcatgg ggaagactgg acagggaatg 7320
gggcacccca aggccacagc cccctcctcc catgagaagg cacactccag gtctcacctg 7380
ggggtgggct ggggcagtcc tgccttgcct gggacaccat gtgtcaagag ccctgcacag 7440
gccaggcctc ggggcttgtg gaaggatgag tgtgtgtgtg tgtgtgtgtg tgcgcgcgtg 7500
tgtgtgtgtg tgcatgttca gatatatgga tggacagaca cacaaataag tgactgacca 7560
gtctgaggtc ctgcccactg ggtagggacc ccggaagtcc tcttggcagc tgtgcttcca 7620
ggagcttcgt tactgcctca ggctctgggc tcccagggaa gctcttggaa gggttcttgt 7680
ttcccttccc atccccttac ttggcccagc tcccttgaag ggtccaagac ctgggggcag 7740
caggtggagt gtgatcagca gggtcccatg tccagctctg gccagccctg cccaccccag 7800
gcccctctga gctccaagtg tctggctgtg ccccccaatt gggcacagct ctgaacctgg 7860
catttagaac ggttcctggg gagctgtgag gagggggtag ggcctgcatg aatagaagct 7920
tctggagcag aaggtgctac ttctgatcat tgattgacca tgatctccag accctgtcta 7980
actcaagcct gggcacgggg cttgggtgtc ttggtgcggg gacacaggac cattctccag 8040
ctgggctggt ggaagctttg gaaactgaat cgcccccctg cctcccaccc tggggagaag 8100
gaggcacctg ctgccagggc tgaggcttgg tggggtttcc cagctatttc gggcctcagg 8160
cactcttggt ttcaccaggc cagctgcact ggggtgaggg ttccagggcc ggtggggagc 8220
ccagcatggg cagggggctg gcctgaggct gtctggggct ggaacagccc aaggatgaaa 8280
acaaccaacg gcagagacaa acaaaacatc tattttccat ctgattgtcc ctccccccac 8340
ccagagagtc agtttccatt attatcaacc cagctgcaca gaggggaaac tgaggctgag 8400
ctcgagccac taactccagc cacaggggcc tggcgctagt cagggctcct cagtcgctgg 8460
ctgcctccag cccctgggac gtcgcccccc gtgagacccc agccaggtgc tccctacccc 8520
ccatcctctg ccctatttct ccccagcaca aatcccgcct cctacatgac attgttcctt 8580
gtctgttgac ttgatttccc tctcccgcaa acatgagctg tctgaacctg gctgtgcctg 8640
ccttaaccct gctgggtttc caggagcagc aggtcctcag aagagagctg aacatgtgac 8700
ttcgctctgg gcagcccctg agaagggggc ttacttacct ggccggtctg gggtctcacc 8760
ttcttcagct actctgccca gcagcccctg gggaccagca ccccttcctt ctgggagctg 8820
ctctctgctg cccagacctt tgcaaacttt ctgtcccctg tgggagccca ggccaagtct 8880
gaccaccact tcccatcctc ctccccagac aggtcaggag aggatgtgtc taggggtctg 8940
agtgggaggc tcccctttgg cctgaaactg tgaagatgag gcccctttct cctctatcat 9000
ttccatagtc agaaagtccc aacatgtccc tgcacaggct gggaactggg tgggcaggga 9060
gggcccatcc tagtgacacc tgtgaggggt ccaggctttg gtgcctggca cggcaactgg 9120
cacattggat gctcagtgaa catcagacct gatgtgagaa gcaggaggga cccgtggcca 9180
gatcaagggt gttggtgttg ctataggaag agagagtcac catgaaggat ggcctgtatg 9240
gaaagaggca cactgcgggt gccctggtgg gtcgtcctgg ctgtgggcta ctctttcctg 9300
gagctgacac gggggctctg tgttgccagc cacagaagtc acccagcccc tccctggctc 9360
ctgtcccaaa gccaggaggc attctccctg ctgcctgtgg tctccccagg aactagggct 9420
gcccagagga gctgtccctt gccggtctct ggacgtggtg tgctgttgct gagtgggaga 9480
tggtattagg gccacccctg gttgtgttgt gagctgggcc tgagtgagct catttctagg 9540
ggctccaggc aggggaccag gaatgtcatg gtgactgcct ggatgtggcc cctagtgagg 9600
ctctcctggc ccctggcccc cattgtaatg tccagcactg cttaccatag tgctaggtgg 9660
ctgggcttgg cttcctcccc ctcattatta gccattatga agaacgtcat tcagtcattt 9720
agcaaacagt tactctgagc ttgggcaacc aaaatttgtt gtttaaactg ggatgttcct 9780
gggagtggaa ggggcactat taataacttc acgagtctct ctgatagatg tgggtggggg 9840
tcctggaggc agcccaggcc tgggtctctg ggcagagccc accattactg ctacaatggg 9900
ccaggcacgg ccaggcctgg gtcccgagct gaggctgggt acacataggc acctgggaaa 9960
ctgcagctga ttggtggcca gtggtctggg gacctggatg gggctaaggg tcaccagggg 10020
ctggacactg ctctagcatc cacctcagct tccagagtca gtggcacaaa ctgggaatgt 10080
cctggaaaat gcaggatgca ggtcatcccc ctcccctcag accttgccca gcccacgtgt 10140
ttcctgggga gaccaccctt gtgaaattac tggccaaaca gggtcaggtt tgatgtggtc 10200
ccaagtgacc aagtgacaaa gactgaccct gatcctgacc ctactgcccc tgctgatgtc 10260
actgtgttga catttccgtg gcccatctgc aatcctcaag atgaccatgt aggagagcag 10320
tttccccaga tcaccccaga aagagggagt cctcacgctt gggttgttac aagaggtacg 10380
ggtgcctttt gaggtgtttg cataactaag cattttggga aaagacctag tcttcccggc 10440
ctccgttgat gccagctagg gatgcttctg aatccccgag ggaactggag catctcacgt 10500
gtggcgcagg ggatcctggg cagatttggg gtcatttttc cttcacgtct cattcagcac 10560
agggaagagg accagtgtca agtcatgaca cacgactctt tcagggccgt agaagctggt 10620
ccttaggtca gggatggagc ccagggtgtg gggtcaacat caaggactcg tgtcctgcag 10680
gcggggtggg tggggaatcc agaacctggc cctggtgtga cagagactct ggagaagagg 10740
atgacatgtc gggagggagg agcaacatcc tcagcattgt gctgtgtcat tagcagtggg 10800
cattgcgagt ggatggtgat tatttcctct atgtccccaa aattcgcatg ttctagttgg 10860
ctggaaactt gattttggac ctttgtgttg aggaatgggg gcttgcctgg gatctggtgg 10920
cctcgttatg gggcatctga gctggtttgc ttgttcccag gtgagtgtcg atgtccccct 10980
tcttgcccct ggattcagtg aatatggggg ttgaagggta atggtgcctt tgtccaggcc 11040
tggctgggga cactctcttg gtggctttgc aggccccaca ggaggctggg cctgatggga 11100
gagtcaccca ctcagttcat agtagctccc agtcctttcc tcccgcaggg ccctgagcag 11160
ccacccccct ctcctccagc agggcccctg caccccctcc caggctattc tgggctctgg 11220
ctttgctgta gaggaagcca cagggcccct ccctgatctg actcagaaca cctccctcag 11280
cccaggctgc agctaagcag ggccagggcc aggacgagtt cctctcaccc catcccccac 11340
tgtgacactc ttccctatac cttgaggggt tcccccagca cagaccaacc ctccttcggt 11400
gtcatgaggc catcactcgt gaggggctgg ccccggtctg agctagacac agtggcatgt 11460
gaagacaggc gtgggctaag gcccaactcg gctactcctg aactgggtgg agcctgggca 11520
gcgctggtgc atccatcatg gttcacgtcc cctctgtgag gtgggcaatg gcagctttag 11580
gcctcagggt cactgtgagg gtcagtgagg gactgtgatg ttcccactgt ggcccaagga 11640
tcacagctgg ggctctctca gatggttctt tcagttaaat cttttcctga gtgtggggag 11700
atgctcctgc tgccccagac actccctggg cagagtgcca accttggaga cttgacaggg 11760
tgggggcagt ggtgtctcca tgtcgttctc caagcttgtg agctcctcta gggcaggtgg 11820
tcctgggctg catacaccag cccctggccc acagctgaga gtttgttgaa tgaatgaatg 11880
agtgagtctg aacaaatgaa tggatgaatg aatgaatgaa aagcccttag ggccgaggag 11940
tcatgaaaag aggcgggcat gggtcagccg gtaacctact gtgtgaccct aggtgggtca 12000
tcacccctcc catcggagcc tcagtcctct catctgtgaa atgggcacat gaacacctgt 12060
cctggctctg ctttgtagac tcagagggca cccccatggc tgccctcctg cctgcctctt 12120
tcacccactg agtcaacaga gaatgaggag cccaggtctg cccatcccac agagccacaa 12180
gggggttcat gcactcagca ccatctcttg gccttgccca ggcacggcct caggatggaa 12240
gggtggccta ggtcaggggc ctgggcaacc actgtgctgc cctgaacacc tgcaggacct 12300
gggcaggctc agcctcctct gcacgcctta gggaaggggc tggctctggg ttgaccttgg 12360
atcagagtcc cagtgcccac catctgtgca gccctgggca gctgtgggac tcgggcaggc 12420
tgctggtctc cgaatctccg tctcctcatc tgtaaggtgt gcgggacatg gacacgtgcc 12480
tcctggggtg gtttgggatc ccatgacata gagaggacag acgccagtgc agggtttccc 12540
tggaagtggc cctgggccag gtggcaggtg aggtagcatc ttcagcagag ccgggagcag 12600
ttccactgtc gagcagtggc catcgagggg ctcagtgata cccagcccag cacctggctg 12660
aacatcggag gacgtgaggg gtgcagcccc tgcttccagg ctcccgtggt gtcccagatc 12720
ggtgctgggc agggcggcac caggagagcg tggtcagcag ccctgggcag ccatcaagcc 12780
tgaggcacca ctgggctgag ggctggggcc ggggaaggag caaggaaccc ttttacattc 12840
cggtagttca tgaatcacac agtgaaagaa agagtcacca agggtgctag ctgccggtgg 12900
ccctgatggg gcagcagcag aacaaagtgg gaggggacca tagaagagag gaccttggcg 12960
gggggtgggg gtgggggtgg gtgggtgagg ggcttcaaga tgacgagaat gatgtgagtt 13020
gccaagccca tcctgaggtc aacagaagga ggacagtgag gggaccattg gattgagcca 13080
cgtgcaggcc actggggctg tgatggggtg gtggtgagac tgctgggctt gaggcaggaa 13140
gggaggggac cgtggaggcc aggagccctt gattaccact tgtaaaaggc aggagagagg 13200
gaggggcagc cagaggaagg cagcattcac attttattac ttcttcctgg caggaccaca 13260
tttgtgctcc taaggtgacc atcaggaggg tctctggccc ttcatactga gatgttgagg 13320
cagagagact gtggtccagg ttctctccag gaagagccca ccattactgc tgcagtgggc 13380
caggcaggac taggtctggg tcccaagccc aggctgggca catatgggtg cttgggaaac 13440
catagttgat tggtggccag tggcctagta cctggatggg gccggggtca ccatgggctg 13500
gtcactgctc cagccccagc atcaacccca gctcccagag tcagtgggga aggggactgg 13560
agtggggtcc gattacagtg accacaggga aatgggggcc acagggaaat gggtgcgggg 13620
agcaggggag attcgggagg tgggtggaag aggaccacgt gctcccatcc tgacagccca 13680
gagcctgcgt gtgcctgggg cggctgctct ctcaaagggc atgcgtctgt cttggggact 13740
gagggtctct gaagtcaggt cgcctcttgc tcgaaagccc cctgccacct tgctcttgac 13800
tttagcacct cctcacaggg cagcacgtgt tatgttatcc gggaggaaat ggaaaccctg 13860
ggaggttctc tggtggggga agggaggagc ggaggtagac taagaggggg tcagcagggg 13920
gagaaggggg aaccagccca gagttctcca gggacgggtg cgtgttgtcc tagcctgtgc 13980
cctgggagtg acaccaggtg agttgagatt tcagtaccca gcatttttgt gactgaagta 14040
aagaaaattc tgatttggcc cttgcctgct tgtacaagtt aactgcttgc tttttgccca 14100
gcatcccttg ttcacacaat gtgatcataa gctgcagatg tcctgtttct ttgtcaagaa 14160
ggaggagata acttcagagt cacaaaagta ttttgcagga gtgaatgcct ttagggacgt 14220
agagaccagc cgctgtcgcc cgcaagtcta gttgcttaag atgttacctg agactgaata 14280
aacacagact tttcccctga aatgccacct ccctcactcc ttagccacat aaaaactccc 14340
tgcttcatcc ttttgttaac atggagtgga ggaatttgct ttcttgtctt cttactttag 14400
ccaaatgaaa taaatctttt tctatctcca agcacttgtg tcagtttttg acctccgctg 14460
catatcaggt acacgaacct gaatctgggg ttctacaaag agtctcacat gtcaccactc 14520
agcccccctc gaacacctac tgcgctcggt gctgggcccc gagaggaccg gggttcctct 14580
ttcccacagc cccagaccca gagccccatg tgctcttccc ttgggagagc agtccctgac 14640
tgaagatgtc aggaattttt ggatgttgag ggagcaactg ggaccaggaa tggaggggat 14700
tgggcttggg gagccacctg ccagggactg actctcctgg aggtggggga caccgtaagc 14760
cctggatcca gaaccaggac tgagatgggg tctctaggaa aaggggactc tcatggtccc 14820
tccctccgag tgccctgacc ctgatatttg acccggagga aggagaaggg gcatgaggaa 14880
tctggctact ccaacctgag gccccgtccc cttccatccc ttgttggtcc aataattctg 14940
tcacttgaat cccgggtccc gggatggggg cctgggtcca gtgggctttg agctctccag 15000
ggaggaagct ggatgaagtg ggtgggcgtg gccaggtggg ctgagggcag ccaggcacct 15060
ggggtccaga gctgagatct gcagttgggt ggaccaggtt tgagtcccta ctgtgacctg 15120
tggcaggtca ctcaggctct ctgggctgtg atgtcaccat cctagagtga ggatcacaat 15180
aggatcttcc tccaagggtg atttggcctg gagggcattt agtctcaggg ggcctgctgg 15240
aagacagtgc cctagagctg tggctaaact cccagtgcct tcctggaacc ccaggaggag 15300
aaggggccac aagagaccag ggatagggag ggcttgggct gggctgggac ggccccccag 15360
gagtggctca gcctggactg ggcagggcat ggagaaaggg agaggaactc gggaaagggg 15420
ctgtggtcgg ctaaattagg ccccgcgggg acagtcgtgt cccaatcctg gacctgtcta 15480
tgtgtcatgt gtggccacag ggactttgca gatgtcatgt caattaggag cctgaggtgg 15540
gaaatgctcc tgggttatcc aggtgggtcc aagctggggt ctttgtagaa gaaagaggga 15600
ggcaggaggg tcagagtgag aggacaagat gtggggatgg agggagacgg agagagagag 15660
aaggaagaga gggagagaag aaggtaggga gggagagaag agcaagagag agatttgaag 15720
atgctgagct caggctctga agttggagga aggggccagg agctgaggtt gtcctctaga 15780
agctggaaaa gtcctggaaa cgaattctcc ccagagtccc cagaaggagc cggccctgct 15840
gggaccctga ttttagcccc caaggactca ttttggactt ctgacctcca gacctgggag 15900
agagtcagtg tgtgatgttt taaggcacta aattaggggt catttgtgat aacagccagc 15960
agccacagga aagtcaaaca ggagccgtgg gagagactcc ccaggatgcc acaagggccc 16020
ctcccaggcc ccacccacag taacccaggc ctgacccctg caggtgcccc cactctacag 16080
aggaggggcc atgcaggagg ggctgggtgg ggctgggtcg tgttctcttc ccccacccct 16140
tcctctcaga gagcagttgg agccccagac tcagggaacc tcacagagaa agtcctgatg 16200
agggacctgg ttttccagtg aaggcccggg atccaatgga gaagtgttcc caaaaatgat 16260
gttcccaaag acggccagtg actttctgtt cacgcacttg agagaatcac catgtctaag 16320
ggctgccaga tagttacctg tgcgtgtgtc aaggttcaca tcccattact actgaggcct 16380
tggatagaac atgttcccac ttttagttgt gacgagatga ctggccccag cattgagaac 16440
accaccttcc cttcagcaaa gggtttgttt aaatttacag aagtggtgaa gtgcttatta 16500
ccctccttgc actggttcct agggagctca gagcctatct tttccaagtg tcccgagcct 16560
cctgtaggcc tttcgtgtga gtctccttcc tggcttcctc ccattcctct taagtgtctg 16620
aacctgctgt caggtgagga atcgaggtgg gtccctcatt gaacagcttg agaagtcagt 16680
ggtgctggag tgtcctggac agtctggctc tcagggatga cagggagggg gtgagggtgg 16740
gtgggagctg agctgggcac agagggagga gggcattccg ggggcaaggg ccaggggcaa 16800
agaggctcca ggcttggagc agggttttca ggctgggaaa agagatggtg ggtgaagggt 16860
gtctctgtta gggcagagat agagggtgta actggagtcc cagccagaga caactccatc 16920
caggcaggag gcagggaggt ggggggctat gctttgagga gaagggggag gaatgaaagg 16980
gcagagggac tggtgttcag tgatcagact tctcctatcc gggcctcttt caccaggaga 17040
caccccggga ggctatgagc ctctccctca gggccacttt ctcactgggt gccaggattc 17100
ccccacccaa cactgagaac ccaggggagg cctcaaatta tgtgtgagat aagaaaagaa 17160
gagagggagc aggatttctc gttgacgatg aggatattta ttgagaaggg ctggatgact 17220
tgggatgggg gcagagaccc ctcccctggg aacctgcagc tccaggcccc tgtgggtggg 17280
gtgagggtcg ggggcctaag agcattctgc aggggccact gtcttctcca cggtgctccc 17340
ttcatgcgtg acccggcagc tgtagcttct gtgggacttc cactgctcgg gcgtcaggct 17400
caggtagctg ctggccgcat acttgttgtt gctttgtttg gagggtttgg tggtctccac 17460
tcccaccttg acggggctgc catctgcctt ccaggccact gtcacggctc ccgggttgaa 17520
gtcacttacg agacacacca gtgtggcctt gttggcttga agctcctcag aggagggtgg 17580
gaacagagtg accgaggggg cagccttggg ctgacctgcg gggtggatga ggggcagggg 17640
gtcagagtcc tggtgtccac ctggggagcc cctgacctca gtcttgaagt gggtatggga 17700
ctaaggccca gggcagggac ctcaggccgg acccttgctg gactgaggtc aggtcagcgg 17760
tgagtggaga cacttgctgt cagatgggag ttgcccccac tcttgggggt cacagacccc 17820
ctcttggatc tgtctctttt tcatattttc catcacctat agacccccac cggtgctggc 17880
tccacactgg atgggatgga gtccaggacc acatctcacc ctgggtattt gtctatcttg 17940
ggggtgtctg tctgaacacc tcctaccagt tccccttgtt ctcatctctt catgcagggc 18000
agctgttggt cctgggttca ggctcttctc tctcacaggg agtgggtttc ttacccacac 18060
atctccctgg tgccatcatt gcagccccca ccccacctcc ctgcagagac ccctctgggc 18120
tgcctggtga gacagggtgt cagtcctggg ggctggattc cagtagatca aaggcctcca 18180
tttgaggcat ttttttttta ctccctgagc tgaacgtgga gctttgtctg ttcgaaagag 18240
tctccatgtc gtgagaagtt atctggggga tctgactctc cagtgggttt tccctgacaa 18300
acaggcaccc gtcccagtca ccgtccctac cagaagtccc tgtcctgggc atctgctctg 18360
aggtcttcct ccagtggagg aattggtaag catccacgtt tagggcctga gttttctgag 18420
acccaccacc ctgtctgtgg tgtcctgcct gtcttggggg atggcgtgtg acccagcgct 18480
gtggggccac cttctcacgg aatattcttc ctctatcttt gtcctcctgc catttcctcc 18540
cccatctctc caagtcctca gtcaaaggcc tcctgtcact gtgtttaatg cagccccgta 18600
actgggaccc acagaggaca gaatcacaga agagggcagg agcccaggca aggaggggca 18660
aagattccag acctccagac aggcttagac cttagccttc gacagacagg aaagggaaaa 18720
actccccgtg tttaacttgg gatctcaaag aggagagaag cggggagact taccgaggac 18780
ggtcagctgg gtgcctcctc cgaacacagc acacagtgac acagccccac acacaaaccc 18840
ctcctgacac acccgacccg ttccccgctg cagcagcttg ggcgcccagg tccagtggcc 18900
ctgtcatgaa gcaggtctgg ccgataggag ggtgaggggg atggcccctc catgcatgga 18960
tgcacacttt actggaagtc agggatccct tcacccccag agggagaggg gagagggagg 19020
aggcatgtct gcacatcaca tctgggtccc ctgctactct ctgtcctgga ggaagccatg 19080
tgtcccggct cagctccttt ggagactgtc accatggaag aagtgagaat cctgtttatg 19140
ccacagggaa ggtggagctg gtcccctatg gagatccgag ttccctggga gggtcctgga 19200
tgcccagcac agcccctagt gggatgccca tgtggtaatg attctaaata gcacaggaga 19260
gtgtgtgtgt atgtatttgc atgcaggcat gtttgtttgt gaatacctgt gtgcctatga 19320
ggtgttcatg tgtgtttatg tttgtgaaca tgtatgtatg tgtgtttgtc tcatagccca 19380
ggccccccat cctgtgctac ctcctgggac aatcatcaac ccggttctta gatcccacat 19440
acagctctta aaaagaccaa ttggtttaca ggcacgtcta tggcaccact ctggaatctc 19500
atgattgact ttgacctccc cagccccact gaccatccgt ggataactgg acattaggta 19560
cttgaggtgt ggtcagtttt gggctggtta cttaggggtg agagagagta gagttgaccc 19620
ttatccccca ggggacttga gtataactgg gacactggtg acacatgtgg gaccaggggt 19680
acccagctgg cctgtggggt gagtgacctg ggtccagagg gtcagggtcc agtctgtgcc 19740
tgcttcagag atagatgtgg gggtagaggg cagggtcctg ggagtcagga acagggtggg 19800
cccctaagga gtaggggaga ccaagggccc atggactgga gaggctcctt ccgcctcaga 19860
aggagggacc ccttgagaga gggaggctgt ccaggggtga ggcctgatga tccgtggagg 19920
gtactcgttc ttctgggcca tggggaacca aggagcggtc gccccaggcc gctggaggtg 19980
gacatgtcca cacaaacaca gcacgtatgg gaaaggggca gtcctggggc ctgctgccca 20040
aggctctgtt ctggaatatt ctctgggcct ttctaggtga tggtggaact acccctcaaa 20100
aacaatccag acttcattcc cacaaggcta aaagaatttt gttcatcttg caggttggac 20160
caatttaggg tagaaaatgt ataaacagaa gcaaaacaca aaacccaggg tttctggttg 20220
actgaggata tttattgagg gtttattgag tgtaggaaga agggctggat gacttgggat 20280
ggggagagag accccctccc ctgggaacct gcagctccag gcccctgtgg gtggggtgag 20340
ggtcgggggc ctaagagcat tctgcagggg ccactgtctt ctccacggtg ctcccttcat 20400
gcgtgacctg gcaactgtag cttctgtggg acttccactg ctcaggcgtc aggctcaggt 20460
agctagctgc tggccgcgta cttgttgttg ctctgtttgg agggtgtggt ggtctccact 20520
cccgtgttga cggggctgcc atctgccttc caggccactt tcacagctcc cgggtagaag 20580
tcactgatca ggcacaccag tgtggccttg ttggcttgaa gctcctcaga ggagggcggg 20640
aacagagtga ccgatggggc agccttgggc tgacctgcgg ggtggatgag gggcaggggg 20700
tcagagtcct ggtgtccacc tggggagccc ctggcctcag ttttcaggtg ggtgaaggac 20760
taaggcccag gatagggacc tcaggctggg cccttgctgt actgaggtca acttggcggt 20820
ggcggggatg cttacctcct gatgggaaac tcctcagcat ctgaggactg aggagaatca 20880
ggcctcttct gctccagcct cctctccaga ttctcccctc cttatcagcc agctctcacc 20940
tcacctatgc tccccgacgc tggctgggtt cagccctggg ccctcgtctt tccttggggg 21000
acgtctctgt ctgaacatcc cctgccaggt ccctcctctg ggtctgttca cgagggcatc 21060
tgtgtcctgt ttttaggttc tcctcccttt tgacaagtga atttcttcct cacatatccc 21120
ccagcaccat cattgcagtc tctgccccac tttcccacag aggccccttg gtggggaggg 21180
gatgtcagtc ctgggagccg ggtcctggga gtccaggaga tggagggctt gcatgtgagg 21240
tatattttct gttctgagcc tggcgctgtg tctgctctat ggggtctccc tgtcgttggg 21300
agatctggct gtcctaggac aaatgtctgt cctgacaggt ccctgtcacc tgcgcccacc 21360
aggagtgcct ccctcagcat ctgctttggg ggtctctctt tttgggtggg atggggaggc 21420
tctaaccttg gactgagtgt cctgagaacc accctgtcca tggcagcctg cctgtcccgg 21480
gggaggagga gggacccagc accctggcgc cacctcacag gacattcttc ctccatcctt 21540
gtcccccttc atttccccaa gtccccagtc aaaggcctcc cttcttggtg tttaaagcag 21600
ccccatagtt gggacccaga accctgggaa gctgaacttt ttccagcatc cttcccctgt 21660
cccatggccc tggtgcccca gcctgagccc ctgctctgct ggtctttggg gactggagac 21720
tctgtgcgag ggagcagaac atcccagagc ccaggggaga atgccccctg agtgacagcg 21780
gcaggttcag gcctgagcag ggagcattaa gaggtcactg ggatcttccc atcatgcccc 21840
accaggtgcc taagaaggga caggctggag gaatttgggg ccaggaaaaa aggcaatggt 21900
ggcagacccc agagagattg agacctctac cctagagaga acagaaagga cagaaaagtc 21960
tccccagatc tcaccctaga cccaaaagaa tagaaaaggg gactcaccga ggacggtcac 22020
cttggtgcca ctgccgaaca cattacactg tgatataacc ctgcacacaa accctcctga 22080
tacacccgac ccaggccacc cccccccaac cccctgcagc tgctcacaag gcccagggtc 22140
cagccccctt ttctcatggg tgggtgagcc ataggtgggg tgaagggggt caccttctac 22200
tgacctgaat atcacttcct tgggggctta ggggttcatc cacctcagtc atgggaaggg 22260
ttgacaggtc tgtgtgtgga attgtctccc aggtaattgc atttctgagg agttgggtgg 22320
cctggatcag ctggtgtcag gaatgccagg gaggaagggg aggtgagcgg ctgggtgacg 22380
ccactgacat ggtgcagctg ggacctcttt gagaagttgg gaatggtggg gagggtcctt 22440
gatgcccccc acatcctcag cactggaggt tatgatggga tgggcttgga atgggaattg 22500
ggggttgtgg gaagaatgac gttgaccaca gggacacaga ccccactgca aggtctgagc 22560
tccagcatcc ttggcccagc tgtcctgaag gagcagctca cagatcactg cccaagtccg 22620
cctcctgaac ccatggggac agcttcctac ctataggcca tgtgtgctgg attagagctg 22680
caatggccca gaggagagct tctcaaggga ggtcataggc ctcactggca gtgtggtttc 22740
ctccaggagc tctacgtgtg ggggatctct gctgtccact tcagctcccc cggcttacac 22800
acacacccac atgtgtgtgc tctgcagtcc cctacatgca cgggtgaccc acacagcctg 22860
tgctctggag tgtcaccggc acggggggca cccacagtgg atgggcatgt gcagtgtggg 22920
gcctggacac acacagcctg gacctgcatc ctggtctggg cccatcacct gaagagctca 22980
cacctgggac acactcctgg caccatgcag tccccaacag tattccccac agcaagcgcc 23040
tcccctgact gctgagatgt ggcctgctgc tccctgatca gaatcccgtc cacatcttct 23100
cctgtctccc tcttggcctg gacagaaaac cctgccccac cctcccatat ccaggggcga 23160
ccccctagtc ccaaagcctg gagacagcag gtctcagctt tgctttgctc atgtcctgac 23220
ctgggcctga ctgcagcccc ttctaccttc ctgatcctcc cagaaggatg cccagcatgg 23280
acatgtgtgt ttatgtgcat tgtgtgtgtg tacacgtgtg tgtgtattat agctcagatc 23340
ccatgctgag ttcttcagaa gaagaatcag cgtcacccaa gctcctggca taaccccaga 23400
atctgacttt gaactcacca gtcaattgac aacttgtgca cagcaggaca ttaggcattc 23460
ataatggtgt cagtgaggag cagagccgac ccttgtcccc taggaatgtt gaatacagct 23520
ggggcatccg gtgacacatg tgggatgaga ggcacccaga gggggatgtg gggtgagtga 23580
ccagggtcca gggggtaagc atcccatcag tgattattat agggagggcc tgtgggggct 23640
gagggcaggg tccctgggat gacgggaaca gagtgtgccc atggagaagg ggagatgctc 23700
taggctttga tgaggggaaa tacaggtggg gtgaccacat ggccttggag ggggatggac 23760
aaacaccttg agagagggat ggcatctgga cagtgagggc cgaggacaac aaagaaggga 23820
gctgagatgt tctcccgggg ccatagggat gtaaggaggg tgtgtccccg ggcagccaga 23880
ggtggacgtg ctcacagggc agcaggaagc acaacagaga cgtgggtaag aatgaagatg 23940
tctggttcct tctgaagact atttccttgt tctggaacat tctatgggga taaggtgatg 24000
gaaaaagtat ggctcagaga aacacgaaga tggtcccagg ctgcattgtc acaagtccaa 24060
aggattctgt tgatctttgg agataaaaaa atttaggatg gaaagtggat aaacaaaaat 24120
gagcagacag catgttttct gattgacaag gaggacattt attgagggtt tattgggtgt 24180
cggcagaagg actggatgac ttggggtggg agggaacacc tctgccctgg gatcctgcag 24240
ctccaggccc ctgtgggtgg ggtgagggtc gggggcctaa gaacattctg catgggccat 24300
tgtcttctcc atggtacttt ctttgtgcgt gacctggcag ctgtagcttc tgtgggactt 24360
ccactgctcg ggcgtcaggc tcaggtagct gctggccgca tagttgttgt tgctctgtgt 24420
ggagggtgtg gttgtctcta tgcccttggt gactagggtg ccattttcct tctatggctc 24480
ctgggtagaa gtcatttatg agacacacca gcatggcctt gttggcttgg agctcctcag 24540
aggagggcgg gaacagagtg accaaggggg tggccttgag cggacctgca gaatggatga 24600
ggggcaggag gtcagagtcc tggtgtccac ctggggagcc cctgacctca gtgcatgagg 24660
agtgttcagg ccccccagta ccagtgcagg acctctcaga tgtggtccac actgtctcag 24720
aagggtgtga catcatgttc ctaaaagaac tctgtcagtc agaaaacctc tgagcttggc 24780
ccctgcccat cgcctgtttg gaaatcttcc aaggacttgg gcttttgtat agacagtgga 24840
ccttcaattg cctggcgctg cctcaccctg tcatcctgac gtgatccggc tctggctgtg 24900
ttctctgagc tctgtgagcc tcttgttaga ttcactctgg aaacttttct cacctgacac 24960
agctgctctg ggttggggga gagtgggtct ctcacgtaag agctcttgtt tgtacccaca 25020
tccgtctctc ctggatcttc tgcagtggag tcagggcctt tgctcaccca agtcccactg 25080
tctgtctgtc ctgggctctt tgtctgtgga gtctgtgtta gagtctctct gtgtttaggg 25140
ccaatctaca gtttttctgc cttgggatat gcctgtcggt gaactcaggg gttcctgctt 25200
ctaggggtgc ctcccacaga gacccatcag ccacctccct gaatgccatg gcctttcgtg 25260
acacttcacc tggctccttc atgtccagag ccttcccgtc cctcctgaca gggcttcatg 25320
ggtcccaggc cagctcaggg ctctctccct gggagcccac agaaacctgg agaggcccct 25380
gcacctccta ccttgttccc agcctggatc cagagtccca cagtccaggg gactgggccc 25440
tgagactctg agttttcatt cccctatctt ggctctgagg gtttcaggtc cttctaaagt 25500
ccaccaggtg gtcactcctt cgagcccctt gttccctctc cctcatgaga tggggcctca 25560
gtttcccttg cacaaagttc gttagacaga agcccaggtg ggggaggaca gaactgagca 25620
agttttaggg aagcagcctg gctctggcag acagacagac agatgagtct cagtaggtca 25680
tccagtctag tgccctacat ctgaggtcag aggtgaaggg gtcttggtga cccactgagg 25740
taagggtcta aacagggagg ggagaggtcc ttgaccaggg cctaggctcc agagagaaag 25800
catcaccaca ggtcaacaca agatacagaa aagaacaaaa gcagcagaaa atttcccagt 25860
accttgggga gaccagggaa ggagggggaa aagactcatc taggacggtc agctcggtcc 25920
cctcaccaaa cacccagtgc tgtgacacag gctcatacaa aaaccctctc tggacgcctc 25980
tacccccaac ccccgctgca gctgtgatgg aggaagctga ggccacagcc cctggtggca 26040
tctgctcatg agggagttca cacggctgcc acactcaccc ccacagagag aaggggacag 26100
ctgacatcct gtgaccagca ggatccctag aaatcctggt tcctggagga cagtggattt 26160
ggttttccca ccaaccatca tgcagccatg gggatgagtt tattggaggg cactgtgtca 26220
ctaggagtga actcccatgg tcagggataa atggtctccc tggtggagct gactcgacac 26280
tgactgcttg gtgacgccct ggggtgatgc agagagtgcc ctctccctcc aggaagaagc 26340
tggttaccct agagtgcggt gtcttgggaa gcttcccatg aacctatctg tgactccagg 26400
agcctcagcc cagccttccc tgggcttgtc ctagttggga tgggcctggc cagtgaggcc 26460
tggctggtcc ccactggaaa tgccagcccc atcctccagg gtaaaatgga aggatctcct 26520
gcacccctca acctggtctc attttggtgg gtgaggtggg gtagtggctg ccactgcctt 26580
attcaaatgt gagggacata aaggagctcc cgagtgtggt ctccaaatat caccttctgc 26640
taagggaggt gaggtcagtg cgggatccca ggcctggggc aggaaaggga catgatgaga 26700
cagaacctct catcctccga gaaatcagga gccatggaag ctcctggggc aatgggagaa 26760
aatcagatgc cacctgagga ggcgcccagt gggtaaatgt ttatgttttg tagccgcatt 26820
gtcattgcaa ttcagtatat ctgcagtgga gcccacatgt cagatgtcct cacacgctag 26880
agctcactcc ggtactacat tgtgctgtgc gccctggagg atggctgggc accagatcat 26940
cagttatcaa agtggtgaac aaaagggaag aatgtacatt ttttcttctt cccaaagcat 27000
gaagcacact cctgagcgca cggtgcagct gctgtgccct cccttctgga agccctcatg 27060
agaaggaggt ggaccgaagt cttgaccatc tgccttcctt ctcatctgag gcgcgaagtt 27120
attgatcatc aaatgcagct aatgtcactg aaagaatgac aacacaacat gggtggcttt 27180
gctggaagta gccacgtgtc ctgggaagcg agtttgccaa tgtccagcct gaaccccctt 27240
gagcctcttg atgctagaac catttttcag gaaaagagag gttgagggaa gcactgggtt 27300
cctgctcagg gaggtggcgc ctgcatcccg actgtgggag gtcccgggac cagctctctg 27360
ctcctgcagc tcctgccttg ccagggaaag ctagagcaat ttgggagaca cctgcagatg 27420
gaatgggtct aaaaacacat tcaccaatga taacgtcaag tattaatcca catagaaatg 27480
aaattaaatc acaaatatgc aacagcacca caaagtcgac aaaaatagac acaatgatat 27540
tcacaagaca tttgataaga ctctcattaa ctatttttga tgtcaagaaa tccttgatat 27600
tctctccagt tgtgtgtgtg atgactagca tttgcttcac acccttgctt gaaggagtag 27660
tttagttatt ctgctgtggg tgggtccgca ttatctgaaa atggatgatg ctgcggactg 27720
gctgatggga accttggagt cattactatt cttctgtctc cctatttttg tgttcagaga 27780
tcttcatcat aaaaatgtac aacttataga gagggtgaag cttgggacag tgtctcccat 27840
gggcttgaat tttcatagct gtgaaatggg tcaaacagag gctgagggac tctgggcacc 27900
tgaaattcaa ttcagctcac ggctgtgatt tggggcaggg gtggctggga ctgagctcca 27960
aaggggcccc tctctttgtg tatcattgtg gaaaaagccc ccaggccttg cagctctgtt 28020
cctgtcctgg ctggccatcc agcagctgct gccatgtccc tgatgaacca gaaacagtgg 28080
gggtcccagc ccgggcacta tggattaacc gagcctgtca aggccttcaa gggaccaaat 28140
tgcccactgt cagggacccc gggatgaggg tgtctctgag tgaggctgcc ggtgcaccat 28200
ggtgcagggg gtgaggggac ggaacaacgt gagtgacaga gggagtgggg cctggtggga 28260
tgggggtgtt tggggcagtt gagatcccgt gaaagcctga ctttgcctat agatagcccc 28320
taggtcatgt tcaccctgtg ctgaccttgc gtgacccagc cttgactcta gtccagaatg 28380
agactctgac acagactctc cccgacaacc atgggatgcc cgttctgtgc ctgggatggt 28440
gtctttgctc atttgtctca gtccacagga gtcctcccct cacacgagct gaccatcaca 28500
ggctcagcca cacaccaagc acatactcac tccaccccag agcctgactt tagaattggg 28560
aacttcatgg ttgagatctc agccacgtgc tggttaactt tgaacctcac cctaagccca 28620
tctgatcata actgatcacc cgtgtgcccc agcctcaccc cactttccag agctagcgac 28680
gtgaacacca gtatcttgca gagcatccta gggctcacta agttggctgg gatggtgagc 28740
aggattctgg acttcctgtt tccctattgc aggacttgta agtgtcttta cttagccacc 28800
ctgtattgtg aaaatctgtg aaattcacct gtgagtttcc attcccagac ctttccacaa 28860
gttcctggtg atggcaccac catggacttc tcacccgata aactgggcac ctggattttc 28920
ctcatccttg cttagaattt aaggaggttg caaactaaat atgagataag aaatgaagac 28980
agacagcagg atttctggtt gacaatgagg atatttattg agggttactg ggtgcaggga 29040
gaagggctgg atgacttgga gtgggagggg agacacatgc cctgatcctg cagctctagg 29100
cccccgtggg taggtgaggg tcggggacct aagaacattc tgcaggggcc actgtcttct 29160
ccacagtgtt cctttcatgc gtgacctggc agctgtagag gttgtgggac ttccactgtc 29220
gggtgccagt cttaggtagc tgctggccgc atacttgttg ctctgtttgg agggtgtggt 29280
ggtctccaca ccctgggtga tggtgatgcc atctatcttc caggccactg tcatggctct 29340
cgggtagaag tcactcatga gacacaccag tgtggccttg tcttggagct ccctgcctct 29400
ggggtcagag gagatgaagg tgtctcagtg accagctgag gcatacaggg gtctgaatag 29460
ggaggagaga gatcagcctc ccaggaccga ggtcccaaag gaaaccctga ccacaggctg 29520
tggcaagtca cagacaaaga tcgaaatcag aataaaattg tcaccaactt ggcagggaaa 29580
gaaagggaag aagagactca tctaaaatga tcagctgggt tcctccacca aatacaaaat 29640
gcggtgacac aggttcatac aaaaactctt ccctggggcc cctaactccc cctccccatc 29700
ccccacctga agctatggtg caggaagcca gaccactgcc cctggaaggc atttgctcag 29760
cagagtccac acacctgcct gcccttctca agctgagatg ggacagtcga ccaagcgtat 29820
gcagtaacgg gacgtctgga aatggcgagg cctgaggagg ttggtgtctg gatcaggttt 29880
tccaggtgac tgtgacccag gaatgggaat gagctccttg agggcatttg cttcacgaag 29940
gagtgaagtg acatggaagg ggacagggat tctctatagg gttgttgtaa ccctgatctc 30000
ttggtgtgac tacagggtaa gagcaggagg cgtcctcagg tgtccccagt gagtgcctta 30060
gaggaggggc agcttgcccc agagtcagca gtcatgggaa gctccaacgt gaccacaacc 30120
acaactccag ggcgtctcac ttccgtcctc cttgtgttgt cttagtttgg gatgggtctc 30180
actaggtttt agtatgaaat gccagcctca acctccaggg agaagttgga agcaagcccc 30240
tgttaccctt tcagggtctt gtctcatttc tgggtatgtc tggagtgtct gactcaaaag 30300
ggctgtgtga gaagcacccc aagtgtggtc actaaatccc acctcccagt tatggggact 30360
agtccacttg gggttaatgg gcaattccag gcacaaggca ggagaaagat gtgcccagga 30420
tagattgtga acagagagcg gaaagccatc gaggtctcct gggttccttc aggaggatcc 30480
tggggccacc agaagaggca ctgagtgggc cacggtgggt cattgtcatc atcaatgaaa 30540
tagaaccatg gtggactcaa gtgagtcaca tacagtaaca taactttgag ctcaccatga 30600
aataattgtt catcttcacg agatggcagg caacatggtc atcattatta agatgctaaa 30660
tgaaaggaaa gactcaacat gtctatgcta tttcttactg aaataagaat cacactccca 30720
gaggagcaaa gaacatatga gggcacacct tttacagaca gtcagtagaa ggaaaaggtg 30780
gtcgaactga aatgcagtca ccttgcatcc atataccatc taatggcact ggatacaaag 30840
tgtgaagccc agctaacgtc acaaatagat gaccccacat gggagcccag tagccaagcg 30900
gtcttgctga aaagtcacac tgagccttgt taaacctttc tggccaagaa ccaattttca 30960
ggaaacgcag aagcagagag gagcgcttgt ttccagcttg gggaggccac aggctgtatc 31020
ctgaccatgg gaaggtcctg ggaccaaccc ccagctcctg tagctcctgc cttgcaagga 31080
aattaaaaat caatgaggaa gatacctgca gacagaacag gtctaaaaac acagtcacca 31140
gtcacaattt caaaccatat tgaatcctca tagaaatgaa atggaaaacc acagaataac 31200
aacaacacaa acacaggtct agtgaaagaa gcataggata tttgtgaagt atttgatggg 31260
aaacattctt tttttgatat gaaagaatta gatatttata tttaggtttg taagaatgta 31320
gttttttggg gggggtccat atttttagag acacaaatgg aatatttaga ctaatggaca 31380
tgatgtctac aatttgcttc aaacaactgt gtaaaagagg ttacttgatt gtgggtgggt 31440
caacatgagc tgtattatcc tgttttttta ttttcttgct gtcagtttcc gtaatatctt 31500
acaaggcagt aattagagag attagtcttg ggacagcacc aggggacatc cagaggggat 31560
cctacccagc agggccattg agaaggtgga gatcaaagcg gtcctctttg ctataggggt 31620
ctcagcgttc acatctatga aatggggcca gacagggtgg tgggaatcag gacccttaag 31680
tttccttcta acttgtaggt tgtgacttga ggcaggggtt ctatgattag gctccaagag 31740
gaaccccttc tctgccccac tatggcccta gagttctctg cccttgcagg ctctgtctca 31800
ggcctggcct ggccacccag cagctctggt gaaggcacct gccacaccgc tgatgtgctg 31860
gaggcaccaa gaaggggcct gacagtgccc aagactgatg aggagggctg ggaagtgcat 31920
ctcccaaggc cacctcactc gctgtcaggg accctgggat gattgtgtct ctgacatcag 31980
ggtgtaggtg cacatggagg ggctgaacca catgattgag ggagggagta ggccctggtg 32040
gggaggggtc taaggtagct gagtcccatg aaaacttgac ctgcctgtag cccttaagtc 32100
acacttaccc tgccctgacc tagtgtgacc tggccctgat tcttgggcga gtatgatttt 32160
gacacagcct ccatcagaca accaatggat gccgattcta tgcttgggat ggtgcctttc 32220
tcatttgacc 32230
<210> 83
<211> 106
<212> PRT
<213> Intelligent people
<400> 83
Gly Gln Pro Lys Ala Ala Pro Ser Val Thr Leu Phe Pro Pro Ser Ser
1 5 10 15
Glu Glu Leu Gln Ala Asn Lys Ala Thr Leu Val Cys Leu Val Ser Asp
20 25 30
Phe Asn Pro Gly Ala Val Thr Val Ala Trp Lys Ala Asp Gly Ser Pro
35 40 45
Val Lys Val Gly Val Glu Thr Thr Lys Pro Ser Lys Gln Ser Asn Asn
50 55 60
Lys Tyr Ala Ala Ser Ser Tyr Leu Ser Leu Thr Pro Glu Gln Trp Lys
65 70 75 80
Ser His Arg Ser Tyr Ser Cys Arg Val Thr His Glu Gly Ser Thr Val
85 90 95
Glu Lys Thr Val Ala Pro Ala Glu Cys Ser
100 105

Claims (77)

1. A method of identifying an individual having non-small cell lung cancer (NSCLC) who is likely to benefit from treatment with an anti-PD-L1 antagonist antibody, the method comprising determining the expression levels of genes CD79A, CD19, BANK1, jcha in, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual, wherein an immune score expression level of the genes that is higher than a reference immune score expression level of the genes identifies the individual as an individual who is likely to benefit from treatment with an anti-PD-L1 antagonist antibody, wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
2. A method of selecting a therapy for an individual having NSCLC, said method comprising determining the expression levels of genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from said individual, wherein an immune score expression level of said genes that is higher than a reference immune score expression level of said genes identifies said individual as an individual likely to benefit from treatment comprising an anti-PD-L1 antagonist antibody, wherein said anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
3. A method of treating an individual having NSCLC, the method comprising:
(a) Determining the expression level of genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from said individual, wherein the determination of the level of immune score expression of said genes in said sample is greater than the reference level of immune score expression of said genes, thereby identifying said individual as one likely to benefit from treatment comprising an anti-PD-L1 antagonist antibody; and
(b) Administering to the individual an effective amount of an anti-PD-L1 antagonist antibody,
wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
4. A method of treating NSCLC in an individual who has been determined to have an immune score expression level of genes CD79A, CD19, BANK1, jchanin, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from the individual that is greater than a reference immune score expression level for the genes, and who has thus been identified as an individual who is likely to benefit from treatment comprising an anti-PD-L1 antagonist antibody, comprising administering to the individual an effective amount of an anti-PD-L1 antagonist antibody, wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
5. A method of identifying an individual having NSCLC who is likely to benefit from treatment with an anti-PD-L1 antagonist antibody, the method comprising determining the expression levels of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 in a sample from the individual, wherein an immune score expression level of the genes that is higher than a reference immune score expression level of the genes identifies the individual as an individual who is likely to benefit from treatment with an anti-PD-L1 antagonist antibody, wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
6. A method of selecting a therapy for an individual having NSCLC, the method comprising determining the expression level of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7 and IGLL5 in a sample from the individual, wherein an immune score expression level of the genes that is higher than a reference immune score expression level of the genes identifies the individual as an individual likely to benefit from treatment comprising an anti-PD-L1 antagonist antibody, wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
7. A method of treating an individual having NSCLC, the method comprising:
(a) Determining in a sample from the individual the expression levels of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5, wherein the determination of the immune score expression level of said genes in said sample is higher than a reference immune score expression level for said genes, thereby identifying the individual as one likely to benefit from treatment comprising an anti-PD-L1 antagonist antibody; and
(b) Administering to the individual an effective amount of an anti-PD-L1 antagonist antibody,
wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
8. A method of treating NSCLC in an individual who has been determined to have an immune score expression level of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 in a sample from the individual that is higher than a reference immune score expression level for the genes, and who has thus been identified as potentially benefiting from treatment comprising an anti-PD-L1 antagonist antibody, comprising administering to the individual an effective amount of an anti-PD-L1 antagonist antibody, wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
9. A method of identifying an individual having NSCLC who is likely to benefit from treatment comprising an anti-PD-L1 antagonist antibody, the method comprising determining the expression level of the genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from the individual, wherein an immune score expression level of the genes that is higher than a reference immune score expression level of the genes identifies the individual as an individual who is likely to benefit from treatment comprising an anti-PD-L1 antagonist antibody, wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
10. A method of selecting a therapy for an individual having NSCLC, the method comprising determining the expression levels of genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from the individual, wherein an immune score expression level of the genes that is higher than a reference immune score expression level of the genes identifies the individual as an individual who is likely to benefit from treatment comprising an anti-PD-L1 antagonist antibody, wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
11. A method of treating an individual having NSCLC, the method comprising:
(a) Determining an expression level of genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from the individual, wherein determining an immune score expression level of the genes in the sample is higher than a reference immune score expression level of the genes, thereby identifying the individual as an individual who is likely to benefit from treatment comprising an anti-PD-L1 antagonist antibody; and
(b) Administering to the individual an effective amount of an anti-PD-L1 antagonist antibody,
wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
12. A method of treating NSCLC in an individual who has been determined to have an immune score expression level of genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from the individual that is higher than a reference immune score expression level for the genes, and who has thus been identified as an individual who is likely to benefit from treatment comprising an anti-PD-L1 antagonist antibody, comprising administering to the individual an effective amount of an anti-PD-L1 antagonist antibody, wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
13. The method of any one of claims 1, 2, 5, 6, 9, and 10, wherein the immune score expression level of the gene in the sample is greater than the reference immune score expression level, and the method further comprises administering to the individual an effective amount of the anti-PD-L1 antagonist antibody.
14. The method of any one of claims 1-13, wherein the reference immune score expression level is an immune score expression level of a gene in a reference population.
15. The method of claim 14, wherein the reference population is a population of individuals having the NSCLC.
16. The method of claim 15, wherein the population of individuals comprises a first subset of individuals who have received treatment with a PD-L1 axis binding antagonist and a second subset of individuals who have received treatment with a therapy that does not contain a PD-L1 axis binding antagonist.
17. The method of claim 16, wherein the reference immune score expression level visibly distinguishes each of the first subset of individuals from the second subset of individuals based on a significant difference between the individual's responsiveness to treatment with the PD-L1 axis binding antagonist and the individual's responsiveness to treatment with the therapy without the PD-L1 axis binding antagonist that is greater than the reference immune score expression level, wherein the individual's responsiveness to treatment with the PD-L1 axis binding antagonist is significantly improved relative to the individual's responsiveness to treatment with the therapy without the PD-L1 axis binding antagonist.
18. The method of claim 16 or 17, wherein the therapy without a PD-L1 axis binding antagonist comprises an anti-tumor agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, or a combination thereof.
19. The method of claim 18, wherein the therapy without a PD-L1 axis binding antagonist comprises a chemotherapeutic agent.
20. The method of claim 19, wherein the chemotherapeutic agent is docetaxel.
21. The method of any one of claims 17 to 20, wherein responsiveness to treatment comprises prolongation of OS, prolongation of Progression Free Survival (PFS), or an increase in determined best overall response (BCOR).
22. The method of claim 21, wherein responsiveness to treatment comprises prolongation of OS.
23. The method of any one of claims 14-22, wherein the reference immune score expression level is the median of the expression levels of each of the genes in the reference population.
24. The method of any one of claims 1, 2, 5, 6, 8, 10, and 13-23, wherein the benefit comprises a prolongation of OS in the individual as compared to treatment without the anti-PD-L1 antagonist antibody.
25. A method of identifying an individual having NSCLC who is likely to benefit from treatment comprising an anti-PD-L1 antagonist antibody, the method comprising determining the presence of a Tertiary Lymphoid Structure (TLS) in a tumor sample from the individual, wherein the presence of TLS in the tumor sample identifies the individual as an individual who is likely to benefit from treatment comprising an anti-PD-L1 antagonist antibody, wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
26. A method of selecting a therapy for an individual having NSCLC, the method comprising determining the presence of TLS in a tumor sample from the individual, wherein the presence of TLS in the tumor sample identifies the individual as an individual who is likely to benefit from treatment comprising an anti-PD-L1 antagonist antibody, wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
27. A method of treating an individual having NSCLC, the method comprising:
(a) Determining the presence of TLS in a tumor sample from the individual, thereby identifying the individual as an individual likely to benefit from treatment comprising an anti-PD-L1 antagonist antibody; and
(b) Administering to the individual an effective amount of an anti-PD-L1 antagonist antibody,
wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
28. A method of treating NSCLC in an individual who has been determined to have TLS present in a tumor sample from the individual and who has thus been identified as an individual who is likely to benefit from treatment comprising an anti-PD-L1 antagonist antibody, comprising administering to the individual an effective amount of an anti-PD-L1 antagonist antibody, wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
29. The method of any one of claims 25 to 28, wherein the presence of TLS is determined by histological staining, immunohistochemistry (IHC), immunofluorescence, or gene expression analysis.
30. The method of claim 29, wherein the histological staining comprises hematoxylin and eosin (H & E) staining.
31. The method of claim 29, wherein the IHC or immunofluorescence comprises detecting CD62L, L-selectin, CD40, or CD8.
32. The method of claim 31, wherein the CD62L or L-selectin is detected using a MECA-79 antibody.
33. The method of claim 29, wherein the gene expression analysis comprises determining the expression level of a TLS gene signature in the tumor sample.
34. The method of any one of claims 1-24, wherein the expression level of the gene is a nucleic acid expression level.
35. The method of claim 34, wherein the nucleic acid expression level is an mRNA expression level.
36. The method of any one of claims 1-24, wherein the expression level of the gene is a protein expression level.
37. The method of any one of claims 1-24 and 34-36, wherein the expression level of the gene is detected in tumor cells, tumor infiltrating immune cells, stromal cells, paracancerous normal tissue (NAT) cells, or a combination thereof.
38. A method of identifying an individual having NSCLC who is likely to benefit from treatment with an anti-PD-L1 antagonist antibody, the method comprising determining the number of B cells in a tumor sample from the individual, wherein a number of B cells in the tumor sample that is higher than a reference number of B cells identifies the individual as an individual who is likely to benefit from treatment with an anti-PD-L1 antagonist antibody, wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
39. A method of selecting a therapy for an individual having NSCLC, the method comprising determining the number of B cells in a tumor sample from the individual, wherein a number of B cells in the tumor sample that is higher than a reference number of B cells identifies the individual as an individual who is likely to benefit from treatment comprising an anti-PD-L1 antagonist antibody, wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
40. The method of claim 38 or 39, wherein the number of B cells in the tumor sample is greater than the reference number of B cells, and the method further comprises administering to the individual an effective amount of an anti-PD-L1 antagonist antibody.
41. A method of treating an individual having NSCLC, the method comprising:
(a) Determining that the number of B cells in a tumor sample from the individual is greater than a reference number of B cells, thereby identifying the individual as an individual who is likely to benefit from treatment comprising an anti-PD-L1 antagonist antibody; and
(b) Administering to the individual an effective amount of an anti-PD-L1 antagonist antibody,
wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
42. A method of treating NSCLC in an individual who has been determined to have a number of B cells in a tumor sample from the individual that is higher than a reference number of B cells, and who has thus been identified as an individual who is likely to benefit from treatment comprising an anti-PD-L1 antagonist antibody, comprising administering to the individual an effective amount of an anti-PD-L1 antagonist antibody, wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
43. The method of any one of claims 38-42, wherein the B cells comprise CD79+ B cells, igG + B cells, and/or plasma cells.
44. The method of claim 43, wherein the B cells comprise plasma cells.
45. A method of identifying an individual having NSCLC who is likely to benefit from treatment with an anti-PD-L1 antagonist antibody, the method comprising determining whether the individual has clonally expanded B cells in a tumor sample from the individual, wherein the clonally expanded B cells in the sample identify the individual as an individual who is likely to benefit from treatment with an anti-PD-L1 antagonist antibody, wherein the anti-PD-L1 antagonist antibody comprises: heavy chain comprising SEQ ID
HVR-H1 sequence of NO. 1, HVR-H2 sequence of SEQ ID NO. 2 and SEQ ID
HVR-H3 sequence of NO 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
46. A method of selecting a therapy for an individual having NSCLC, the method comprising determining whether the individual has clonally expanded B cells in a tumor sample from the individual, wherein the clonally expanded B cells in the sample identify the individual as an individual likely to benefit from treatment comprising an anti-PD-L1 antagonist antibody, wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
47. A method of treating an individual having NSCLC, the method comprising:
(a) Determining that the individual has clonally expanded B cells in a tumor sample from the individual, thereby identifying the individual as an individual likely to benefit from treatment comprising an anti-PD-L1 antagonist antibody; and
(b) Administering to the individual an effective amount of an anti-PD-L1 antagonist antibody,
wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
48. A method of treating NSCLC in an individual who has been determined to have clonally expanded B cells in a tumor sample from the individual and who has thus been identified as an individual who is likely to benefit from treatment comprising an anti-PD-L1 antagonist antibody, the method comprising administering to the individual an effective amount of an anti-PD-L1 antagonist antibody, wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
49. The method of any one of claims 45-48, wherein the clonally expanded B cells are clonally expanded plasma cells.
50. The method of any one of claims 1 to 24 and 34 to 37, wherein the sample is a tissue sample, a cell sample, a whole blood sample, a plasma sample, a serum sample, or a combination thereof.
51. The method of claim 50, wherein the tissue sample is a tumor tissue sample.
52. The method of any one of claims 25-33 and 38-49, wherein the tumor sample is a tumor tissue sample.
53. The method of claim 51 or 52, wherein the tumor tissue sample comprises tumor cells, tumor infiltrating immune cells, stromal cells, NAT cells, or a combination thereof.
54. The method of any one of claims 51-53, wherein the tumor tissue sample is a formalin-fixed and paraffin-embedded (FFPE) sample, an archived sample, a fresh sample, or a frozen sample.
55. The method of any one of claims 1 to 54, wherein the NSCLC is non-squamous NSCLC.
56. The method of any one of claims 1 to 54, wherein the NSCLC is squamous NSCLC.
57. The method of any one of claims 1 to 56, wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain variable region comprising the amino acid sequence of SEQ ID NO 7; and
a light chain variable region comprising the amino acid sequence of SEQ ID NO 8.
58. The method of claim 57, wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the amino acid sequence of SEQ ID NO 9; and a light chain comprising the amino acid sequence of SEQ ID NO 10.
59. The method of claim 58, wherein the anti-PD-L1 antagonist antibody is atlizumab.
60. The method of any one of claims 1-59, wherein the subject has not been treated for the NSCLC.
61. The method of claim 60, wherein the subject has not been administered a PD-L1 axis binding antagonist.
62. The method of claim 60 or 61, wherein the individual does not have EGFR or ALK genomic tumor aberrations.
63. The method of any one of claims 1-59, wherein the subject has been previously treated for the NSCLC.
64. The method of claim 63, wherein the subject has been previously treated for the NSCLC by administering to the subject a platinum-containing chemotherapeutic agent, and wherein the subject is non-responsive to the chemotherapeutic agent.
65. The method of any one of claims 3, 4, 7, 8, 11-24, 27-37, 40-44, and 47-64, wherein the anti-PD-L1 antagonist antibody is administered as a monotherapy.
66. The method of any one of claims 3, 4, 7, 8, 11-24, 27-37, 40-44, and 47-65, wherein the method further comprises administering an effective amount of one or more additional therapeutic agents.
67. The method of claim 66, wherein the one or more additional therapeutic agents comprise an anti-tumor agent, a chemotherapeutic agent, a growth inhibitory agent, an anti-angiogenic agent, radiation therapy, a cytotoxic agent, an immunomodulatory agent, or a combination thereof.
68. The method of any one of claims 1-67, wherein the individual is a human.
69. A kit for identifying an individual having NSCLC who is likely to benefit from treatment with an anti-PD-L1 antagonist antibody, said kit comprising reagents for determining the expression levels of genes CD79A, CD19, BANK1, JCHAIN, SLAMF7, BTK, TNFRSF17, IGJ, IGLL5, RBPJ, and MZB1 in a sample from said individual, wherein an immune score expression level of said genes that is higher than a reference immune score expression level of said genes identifies said individual as an individual who is likely to benefit from treatment with an anti-PD-L1 antagonist antibody, wherein said anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
70. A kit for identifying an individual having NSCLC who is likely to benefit from treatment with an anti-PD-L1 antagonist antibody, the kit comprising reagents for determining the expression levels of genes MZB1, DERL3, JSRP1, TNFRSF17, SLAMF7, IGHG2, IGHGP, IGLV3-1, IGLV6-57, IGHA2, IGKV4-1, IGKV1-12, IGLC7, and IGLL5 in a sample from the individual, wherein an immune score expression level of the genes that is higher than a reference immune score expression level of the genes identifies the individual as an individual who is likely to benefit from treatment with an anti-PD-L1 antagonist antibody, wherein the benefit comprises an increase in the Overall Survival (OS) of the individual as compared to treatment without the anti-PD-L1 antagonist antibody, wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
71. A kit for identifying an individual having NSCLC who is likely to benefit from treatment comprising an anti-PD-L1 antagonist antibody, the kit comprising reagents for determining the presence of a Tertiary Lymphoid Structure (TLS) in a tumor sample from the individual, wherein the presence of TLS in the tumor sample identifies the individual as an individual who is likely to benefit from treatment comprising an anti-PD-L1 antagonist antibody, wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
72. A kit for identifying an individual having NSCLC who may benefit from treatment comprising an anti-PD-L1 antagonist antibody, the kit comprising reagents for determining the expression level of genes CCL2, CCL3, CCL4, CCL5, CCL8, CCL18, CCL19, CCL21, CXCL9, CXCL10, CXCL11, and CXCL13 in a sample from the individual, wherein an immune score expression level of the genes that is higher than a reference immune score expression level of the genes identifies the individual as an individual who may benefit from treatment comprising an anti-PD-L1 antagonist antibody, wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
73. A kit for identifying an individual having NSCLC who is likely to benefit from treatment with an anti-PD-L1 antagonist antibody, the kit comprising reagents for determining the number of B cells in a tumor sample from the individual, wherein a number of B cells in the tumor sample that is higher than a reference number of B cells identifies the individual as an individual who is likely to benefit from treatment with an anti-PD-L1 antagonist antibody, optionally wherein the B cells comprise plasma cells, wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
74. A kit for identifying an individual having NSCLC who is likely to benefit from treatment with an anti-PD-L1 antagonist antibody, the kit comprising reagents for determining whether the individual has clonally expanded B cells in a tumor sample from the individual, wherein the clonally expanded B cells in the sample identify the individual as an individual who is likely to benefit from treatment with an anti-PD-L1 antagonist antibody, wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the HVR-H1 sequence of SEQ ID NO. 1, the HVR-H2 sequence of SEQ ID NO. 2, and the HVR-H3 sequence of SEQ ID NO. 3; and a light chain comprising the HVR-L1 sequence of SEQ ID NO. 4, the HVR-L2 sequence of SEQ ID NO. 5, and the HVR-L3 sequence of SEQ ID NO. 6.
75. The kit of any one of claims 69 to 74, wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain variable region comprising the amino acid sequence of SEQ ID NO 7; and a light chain variable region comprising the amino acid sequence of SEQ ID NO 8.
76. The kit of claim 75, wherein the anti-PD-L1 antagonist antibody comprises: a heavy chain comprising the amino acid sequence of SEQ ID NO 9; and a light chain comprising the amino acid sequence of SEQ ID NO 10.
77. The kit of claim 76, wherein the anti-PD-L1 antagonist antibody is atuzumab.
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